Jan
08
2022

Sleep Training to Prevent Insomnia and Depression

By | depression, Insomnia, sleep

A new study describes that sleep training to prevent insomnia and depression is desirable. Notably, the study published in JAMA Psychiatry took 291 people age 60 years and older and followed them for three years. In this case half the participants received treatment with sleep training, the other half treatment with cognitive behavioral therapy. The other half was the control who received sleep education therapy from a public health educator. It is important to realize that both groups received 120 minutes weekly group sessions for two months. That is to say, following training of 2 months the subjects were followed for 36 months. It must be remembered that they completed monthly questionnaires to monitor for depression and insomnia. At the end of the study almost 1/3 of the cognitive behavioral group still were free of insomnia.

The control group who received sleep education therapy initially showed no longer any

improvement. In other words, the initial progress did not last with sleep education only. The study was also published in CNN.

Results about rates of depression

Those subjects of the cognitive behavioral therapy group who had a sustained remission of their insomnia disorder had a rate of 82.6% less depression. This was in comparison to the subjects who did not sustain their treatment against insomnia. Dr. Pim Cuijpers commented that the results of the study show “a completely new and innovative way” of tackling the growing problem of depression. Dr. Cuijpers is a professor of Clinical Psychology at the Free University of Amsterdam.

A brief background about depression in older patients

Depression is common in people above the age of 60. About 30-50% of this age group develop depression. Part of this could be that older people often do not get enough sleep as middle-age or younger adults do. Melatonin production declines with older age and this may play a role in insomnia of older people. On the other hand, one of the major symptoms of depression is a lack of sleep. It seems that a lack of REM sleep, the deep sleep that makes us dream, is responsible for both troubles, sleeping (insomnia) and depression.

Cognitive behavioral therapy administered by a therapist is effective for insomnia

It is important that a therapist administers the cognitive behavioral therapy. There are recordings available online that provide cognitive therapy, but they are not individualised. Dr. Irwin said: “That’s why CBT-I is so effective in person, because the therapist is helping that individual navigate and negotiate with themselves — and it can be really hard work,” Irwin added. “I believe that’s also why CBT-I apps or online tools often don’t work — people get frustrated, disappointed or angry at themselves, and they basically stop the work.”

The rationale for cognitive behavioral therapy (CBT)

CBT for insomnia has five components: Stimulus control, sleep restriction, sleep hygiene, relaxation and cognitive behavioral therapy. Researchers gave the program the name CBT-I. Sleep hygiene and relaxation involve these sleeping habits: going to bed at the same time every day, eliminating noise and blue light from electronic devices. Also, you want to keep your bedroom cool, take warm baths and do yoga for relaxation.

Stimulus control and sleep restriction

Stimulus control involves getting out of bed, if you can’t sleep. Dr. Irvin said: “Most people stay in bed, fretting about not falling asleep, which then turns the bed into a negative space. Instead, people are taught to get up after 10 minutes of tossing and turning, do quiet, non-stimulating activities, and not to come back to bed until they are sleepy.” Sleep restriction means that a person lies in bed only to sleep plus 30 minutes. It is a way to make people with insomnia get out of bed instead of lying there awake.

Cognitive behavioral therapy

Cognitive behavioral therapy disrupts irrational thoughts and beliefs about sleep. Patients with insomnia often think “I can never sleep” or “I might die if I don’t sleep tonight.” A therapist has training to help the patient find a way back to a more realistic mindset. Eventually the patient accepts the bed as a welcoming place.

Cognitive behavioral therapy is effective in preventing depression

Dr. Irwin pointed out that chronic insomnia often leads to depression. A dangerous consequence of depression can be preoccupation with suicide. A certain percentage of patients with depression in any age group want to kill themselves. This is where cognitive behavioral therapy can intervene and make a huge difference. As mentioned earlier almost 1/3 of patients who received cognitive behavioral therapy for two months retained their normal sleep pattern. It was among this group that 82.6% had no depression compared to a control group. These are very important statistics. Dr. Irwin said: “We have shown that we can actually target insomnia with cognitive behavior therapy and prevent depression from occurring”.

Sleep Training to Prevent Insomnia and Depression


Sleep Training to Prevent Insomnia and Depression

Conclusion

A new study in JAMA Psychiatry describes that sleep training to prevent insomnia and depression is feasible. Sleep researchers used cognitive behavioral therapy sessions for two months on subjects who suffered from insomnia. The treatment group had profound effects with respect to improving insomnia and depression. Almost 1/3 of subjects treated with cognitive behavioral therapy returned to a normal sleeping pattern. And this subgroup of patients had 82.6% less depression. The lead author, Dr. Irwin thinks that cognitive behavioral therapy could become the new way of how to treat and prevent depression.

Nov
03
2018

When you are sleepless

By | andropause, Anxiety, Drugs, Insomnia, Menopause, Mortality, sleep, stress, telomeres, testosterone

You are not alone when you are sleepless. Insomnia is a widespread problem in society.

Previous review of the topic of insomnia

I have reviewed the topic of insomnia before in a blog.

Briefly I pointed out that in some people there is a mutation of the gene that controls the circadian sleep rhythm. It is called the CRY1mutation. Some people have sleep disturbances from working night shifts. I mentioned the blue light of electronics that is produced by the TV screens or computer screens. The more you are exposed to it, the more it stimulates the brain to produce serotonin. This undermines the melatonin production, and as a result the person finds it extremely difficult to fall asleep. Children playing with i-phones, tablets or watching children’s programs on television can have sleep disturbances from the blue light. Blue has the frequency that over stimulates the brain and interferes with melatonin production. Drug and alcohol abuse can also interfere with the normal circadian sleep rhythm and cause insomnia.

Hormone factors of insomnia

For natural sleep to occur, we need melatonin which the pineal gland releases in the evening. It initiates and maintains sleep during the night. The natural opponent of melatonin is cortisol, the stress hormone, from the adrenal glands. Both hormones need to be in balance to allow you to sleep normally. Shortly before we wake up in the morning melatonin production goes down and cortisol production is up. Cortisol levels are low at night and high during the day. So it is cortisol that keeps us going throughout the day. But an excess of cortisol from chronic stress can also interfere with falling asleep and sleeping through the night.

Stress and insomnia

When we feel stressed, cortisol production goes way up. This has consequences regarding our sleep pattern. It can interfere with falling asleep, causes us to wake up from a deep sleep in the middle of the night and can give us problems falling asleep again. Chronic stress exposure leads to high cortisol production by the adrenal glands, which in turn will lower melatonin and cause sleep disturbances. Older people (above the age of 50) have very little melatonin production left, as there is an age-related decline of melatonin production. The melatonin production is highest in younger years and lowest in older age.

What to do when you are sleepless

There are several over-the-counter remedies, which in combination can be quite effective.

Melatonin for when you are sleepless

Melatonin (3 mg at bedtime) is a good start to see what it does for your sleeplessness. Taking a small amount of melatonin at bedtime we can re-establish the balance between cortisol and melatonin, which helps the circadian hormone rhythm and sleep pattern to come back. Some people wake up in the middle of the night and find it difficult to fall asleep again. If this happens at 3 AM, a good remedy at this time is to take another 3 mg of melatonin. Melatonin stays in the system for about 4 hours. Light during the day de-activates the effect, when light hits the retinas upon opening your eyes. You should not exceed 6 mg of total melatonin overnight. Otherwise it will interfere with the balance of cortisol and melatonin, lowering cortisol levels, which would rob you of energy during the day.

Phosphorylated serine (Seriphos)

A supplement that is freely available in the US (but not in Canada) consists of a simple amino acid. As this link shows (second item in the link) phosphorylated serine Seriphos) helps to down-regulate cortisol levels (lowering them). This means that melatonin gets the upper hand and you can sleep again.

The dosage for phosphorylated serine (Seriphos) varies from person to person, but will be in the range of 1000 mg to 3000 mg in the evening. After about 30 days the circadian rhythm may have recovered and you can stop the Seriphos. A one-day pause is required once a month for resetting the hormone receptors. Should you still have problems sleeping, you can continue with it for another month and pause again for a day. Seriphos has very few side effects.

Valerian root capsules

Another useful sleep aid is valerian root (as capsules). 500 mg to 1000 mg will help you to relax. It does not have the side effect of feeling groggy the next morning.

Other considerations when you are sleepless

Hormone problems like thyroid abnormalities (too much or too little thyroid hormones) are issues that your doctor has to investigate. Women in menopause often have sleep disturbances due to a lack of estrogen and progesterone. A knowledgeable healthcare professional is able to take care of that by prescribing bioidentical hormone creams.

When men approach andropause (the equivalent of menopause in women), they lose testosterone production. This can cause insomnia. The doctor can verify the hormone loss by a blood test. Replacement with either bioidentical testosterone cream or injections will rebalance testosterone levels. Insomnia may disappear. It is essential not to overdose testosterone, as this can also cause insomnia.

Sleep lab for when you are sleepless

When home remedies do not help, it may be time to check into one of the sleep labs to diagnose the kind of sleep disorder you are suffering from. Here is an overview what is happening there.

Essentially you get hooked up to monitors and are encouraged to just sleep as you would normally do. The physician in charge of the lab will later explain to you what the monitors showed, and tell you what type of sleep. According to the findings your doctor will recommend what measures are appropriate to remedy the situation.

Treatment for insomnia when over-the-counter remedies fail

Short acting benzodiazepams

When anxiety is not a problem, but only insomnia is (falling asleep or staying asleep) lorazepam 1 mg (Ativan) or temazepam 10 mg (Restoril) are shorter acting benzodiazepams that will help. It is not a permanent but a short “emergency break” for intermittent use, so that the GABA benzodiazepine receptors have time to recover. Otherwise, with continuous use tolerance would set in. This means higher and higher doses of the sleep medication would be necessary to achieve the same effect. Another non-benzodiazepine is Zolpidem 5 mg (Ambien). Even though this medication is not a benzodiazepine, it works on stimulating the same GABA benzodiazepine receptors.

Longer acting benzodiazepams combined with antidepressant Trazodone

For several years the combination of a small amount of the longer acting benzodiazepams, clonazepam (Rivotril) at 0.5 mg combined with a small amount of the anti-depressant trazodone (Oleptro or Desyrel) at 50 mg at bedtime has been has been in use quite successfully.

But there is a concern of drowsiness caused by Rivotril as this link shows.

Trazodone, which is an antidepressant has a sleep cycle restoring effect at low doses and has less side effects, because it is used at ¼ the dose for a full-blown depression. Males are often complaining that it reduces their sex drive, and it may cause erectile dysfunction.

Clonazepam side effects

Rivotril was originally in use to control epileptic seizures and anxiety. The combination therapy for sleep disorders uses Rivotril at ¼ of the regular dose. Although it is good as a sleep aid, it has a long half-life and stays in the system well into the next day. This may present as sleepiness and cause falls in elderly patients because of clouded attention. Replacement by one of the medium long acting benzodiazepams could be the solution. A drug pause for 1 day will help to reset the GABA benzodiazepine receptors and prevent tolerance from happening. Knowing all those effects and side effects it is wiser to reserve the use of these medication strictly when everything else has failed!

When you are sleepless

When you are sleepless

Conclusion

As I mentioned before, you are not alone when you are sleepless. Insomnia can present as having problems to fall asleep, but it may present in others as a problem in the middle of the night waking up and having problems going back to sleep again.

I described non-conventional methods to help you to sleep using melatonin, Seriphos and valerian root capsules. If this fails, a sleep lab investigation may be necessary to get to the bottom of your insomnia problem. Physicians often prescribe short acting benzodiazepams like lorazepam (Ativan) and temazepam 10 mg (Restoril).

Other possibilities to treat insomnia

There are other possibilities to treat insomnia, with a combination of a low-dose antidepressant (trazodone, brand name Oleptro in the US) and low-dose anti-seizure and anti-anxiety drug clonazepam (Klonopin or Rivotril). Anxiety can often be a big component in insomnia and this treats both. On the other hand, anxiety is a separate problem, which needs professional treatment. There can be side effects of sleepiness from clonazepam and men complain of a lack of sex drive and erectile dysfunction from trazodone. Help is available when you are sleepless. But you need professional help to work on the problem and find the solution.

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Jul
25
2015

Light Can Interrupt Your Circadian Rhythm

By | Cardiovascular disease, Circadian rhythm, Sleeep

A light bulb company from Florida has decided to put warning labels on the light bulbs they manufacture to tell you that artificial light can have health consequences: light can interrupt your circadian rhythms.We do not easily see that it should matter whether you use artificial light at night or not.

Introduction

What we do know is that in the evening when we close our eyes and shut out the light the melatonin production gets elevated, we get sleepy, and we fall asleep. During our sleep the immune system receives a boost from the higher melatonin blood concentration, while cortisol takes a rest and levels are lower overnight. Melatonin is also a powerful anti-cancer agent and this would fit in with the study that found that a loss of the clock gene in shift workers was correlating to a worse prognosis regarding their breast cancer.

There are other diseases that can develop when the circadian rhythm is not maintained. Here are a few examples: neurodegenerative disease, cancer, depression, and sleep disorders.

This link shows how the internal central clock in the suprachiasmatic nucleus of the hypothalamus is responsible for keeping time inside of us. The suprachiasmatic nucleus is situated just above the optic chiasm, hence the name.

The clock gene influences the peripheral clock via the clock genes in each organ to be synchronized. If you disregard your internal clock, expose yourself to prolonged artificial lighting and delay going to sleep in time you will create a disorganized central/peripheral rhythm, which weakens the immune system, disrupts your normal hormone rhythms, and ultimately this can lead to disease.

Breast cancer from interrupted circadian rhythm

Women in California were followed with regard to developing breast cancer and nightly exposure to artificial light.

In this study the authors found a 1.34-fold higher breast cancer risk in premenstrual women exposed to high levels of ambient light at night compared to women who were not.

Similarly, a 2014 study showed a difference with regard to breast cancer rates in women who were working night shifts and women who worked normal hours.

The study showed a loss of clock genes in shift workers with breast cancer that was associated with a worse prognosis of their breast cancer compared to those who were not shift workers and had normal clock genes.

Is it a good idea to tell people that light bulbs can be harmful?

Fred Maxik, the Florida based Lighting Science Group chief officer thinks it is a good idea. Dr. Paolo Sassone-Corsi, the director of the Center of Epigenetics and Metabolism at the school of medicine at University of California Irvine who has authored many studies on the negative effect of artificial lighting on the circadian rhythm also thinks that labeling light bulbs is a good idea. He cautions that there are even more powerful light sources like TV’s and computers that can disrupt the circadian rhythm the later it gets in the evening. “And think about how many people look at Facebook at 2 a.m. That is way more disruptive, but this is certainly a good start; we need to keep increasing awareness in a larger population that light at the wrong time of day can harm you” Dr. Sassone-Corsi added.

It is somewhat nebulous what effects a disruption of the circadian rhythm has in our system. But we do know that sleep deprivation can cause overeating and obesity, memory loss, short attention span, diabetes, depression, car accidents, sudden cardiac arrest and sudden cardiac death due to deadly electrical heart rhythms (ventricular fibrillation).

This 2015 study suggests that melatonin should be used to treat people who are involved in shift work. This will help to reset the circadian rhythm to normal.

Origin of circadian rhythm disorders

Sleep disorders can start in childhood, usually when school starts with structured days and normal bedtime hours, followed by school holidays and weekends where late bedtime hours or irregular sleep habits are the rule. Circadian rhythm disorders are not disorders of sleep quality, but rather disorders in timing of sleep (Ref.1). Circadian rhythm disorders start usually when the child enters school, but can develop as late as in adolescence. 10 to 18% of children and adolescents have circadian rhythm disorders. It is not known why some children find it easy to switch between the irregular sleeping habits of summer to the regular sleeping habits during school days. But others are not able to switch and have problems in school with inattention, daytime sleepiness, irritability, hyperactivity and combativeness. Circadian rhythm disorder tends to persist and can turn into adult circadian rhythm disorder. There are also morning types and evening types (in medical lingo morning chronotypes and evening chronotypes).

Delayed sleep phase disorder

One of the most frequent subtypes of circadian rhythm disorder is the delayed sleep phase disorder. This is what is often found in adolescents who push for a later and later bedtime. The fact that they sleep in until 11 AM or 1 PM reinforces it. They like to shut their windows with a black curtain to keep the sunlight out. At night they like to spend time in front of a computer or the TV. They like to go to sleep only at 1, 2 or 3 AM. They may not be aware what is happening to them: the lack of morning sunlight exposure in the early morning hours of the day leads to a delayed setting of the dim light melatonin onset (DLMO) at the end of the day, which is regulated through the suprachiasmatic nucleus (a part of the hypothalamus). By taking frequent blood or saliva melatonin levels researchers have been able to measure corresponding melatonin levels at the time of the DLMO.

We know from research with astronauts in space travel that melanopsin is produced in the blue-light-sensitive photopigment in the ganglion cell layer of the eye. Melanopsin travels from there along the optic nerve into the suprachiasmatic nucleus, where it helps to set the circadian rhythm for the day.

The day is defined by first opening our eyes when we wake up, getting the first melanopsin dose in the circadian rhythm headquarters of the hypothalamus; two yours before we fall asleep we have the dim light melatonin onset where melatonin is just starting to rise, which makes us gradually tired. Maybe the cave men and women sat around the fireplace and told each other stories. We could listen to soft music in a less brightly lit area.

Treatment of delayed sleep phase disorder

It is important to note that people with a delayed sleep phase disorder (DSPD) do not have a sleep disorder: they have normal sleep at an abnormal time (Ref.1)

Here is how the sleep specialist treats delayed sleep phase disorder.

  1. Exposure to sunlight or to blue LED light at the time of awakening for 20 minutes to 1 hour is key to resetting the circadian rhythm to an earlier point than has been the case. This involves that the child, adolescent or adult has to get used to setting an alarm clock to a desired time in the morning. In order the preserve the resetting of the circadian rhythm towards the evening it is important that from 5 to 6 PM in the evening exposure to the bright lights is avoided. This includes light emission from TV’s, i-phones or computers. The eye would otherwise reset the circadian rhythm via the melanopsin mechanism to a later time.
  2. Melatonin treatment is used to advance or delay circadian rhythms. Melatonin also has a sedating effect, but only about 20% respond to that within 30 minutes by falling asleep. The doses in commercial products override the circadian rhythm effect. Sleep experts use much smaller doses of melatonin to reset the internal clock. Thinking of an adolescent who goes to sleep at 2 AM, the DLMO would be at midnight. To phase advance an individual like that a small amount of melatonin (0.5 to 1.0 mg) would be given at 6 to 8 PM (that is 4 to 6 hours before the DMLO point or 6 to 8 hours before the previous bedtime). The morning exposure to bright light works together with the early evening dose of a tiny dose of melatonin, which by itself is not enough to put the person to sleep at that time.
  3. Supportive sleep hygiene methods: It is important that the parents understand the underlying problem. If necessary, they may have to seek the advice of a sleep expert and discuss the details with him/her. 2 hours prior to bedtime the child needs to be exposed to dim light, which is light that does not have blue light in it. The level of dimness is such that reading is difficult. No TV, no cell phone or I pad is allowed. In this dim light atmosphere melatonin is expressed normally and will be produced and released by the pineal gland in higher amounts. Establish a regular bedtime with which all family members can agree. This is best kept on school days, holidays and weekends. If you would sleep in, you would switch your time machine in your head to another time zone further west and it would be an effort to switch it back! There are many children and adolescents who can switch back and forth easily, but the person with DSPD cannot switch easily and would get stuck again in the familiar late sleeping pattern.

Avoid cola and other caffeinated beverages, including green tea, as they stimulate. The bedroom should be dark, quiet and comfortable. Sound machines have not been shown to enhance sleep (Ref.1).

Light Can Interrupt Your Circadian Rhythm

Light Can Interrupt Your Circadian Rhythm

Conclusion

Circadian rhythm disturbances are more common than previously thought of. There is a certain percentage of children who enter the school system that develop delayed sleep phase disorder. This often stays with them into adolescence and can even carry on into adulthood. Two simple tools have been shown to treat this: early morning light exposure for 20 minutes to 1 hour and a small dose of evening melatonin to reset the circadian rhythm. There likely are thousands of untreated people with circadian rhythm disorders. As not all circadian rhythm disorders are the same it is advisable to seek the advice of sleep disorder expert, if sleep patterns are problematic.

 

References:

1. John H. Herman, Chapter 5, 35-43. “Circadian Rhythm Disorders”

Principles and Practice of Pediatric Sleep Medicine

Second Edition. Stephen H. Sheldon et al., 2014, Elsevier Inc.

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Feb
15
2014

Melatonin More Than A Sleeping Aid

By | Anti-aging medicine, Cancer, Health, Hormones, Insomnia, Prevention, Vitamins and supplements

Melatonin has been available to the public in the US since 1992. It is usually used as a sleeping aid or for jet lag related sleeping problems. However, in the last decade much more data about melatonin has come out that has proven that melatonin is a major hormone. The pineal gland contains another brain hormone, serotonin, which is converted into melatonin within that gland. Melatonin is a key hormone that regulates the sleep/wake cycle. It works in concert with cortisol, which has the highest level in the morning while melatonin has its highest level in the evening and during the night. Melatonin also regulates the menstrual cycle and determines when women get into menopause.

Lately new information has come to the forefront showing that there are connections to Alzheimer’s disease, Parkinson’s disease, stroke size and recovery from strokes. Even traumatic brain injury can be minimized when enough melatonin is present. In addition melatonin is an important anti-oxidant.

Finally, there is evidence that melatonin helps to determine how well we age.

In the following I like to review some of the evidence for all of these claims.

1. Melatonin as a hormone

Melatonin levels were found to be very low in breast cancer and prostate cancer patients. It has been determined that the immune cells have melatonin hormone receptors and need melatonin for stimulation. Because of the immune stimulatory effect of melatonin, it is often given as a cancer adjuvant treatment to other cancer treating modalities. Ref. 1 describes that melatonin regulates the female hormones (LH, FSH), which then determine when a woman has her menstrual period and also when she eventually enters menopause. The pineal gland is the master gland for the diurnal hormone rhythms.

Melatonin More Than A Sleeping Aid

Melatonin More Than A Sleeping Aid

2. Melatonin levels decline with age

Melatonin levels in both men and women decline as we age. This figure shows that the highest melatonin levels are reached by the age of 10; by the age of 40 only 15% of the youthful levels remain while by the age of 55 only 5% or less of the original youthful levels are left. This explains why older people are more prone to infections (missing immune stimulation) and why the sleep pattern in older people is changed (shorter periods of sleep, less restful sleep). Ref. 1 points out that with insulin resistance (from diabetes or due to excessive sugar and starch consumption) cortisol levels are chronically elevated, which in turn inhibits melatonin production.

3. Melatonin protects from neurodegenerative diseases

A newer application of melatonin is as a preventative in the neurological field, particularly in the area of Alzheimer’s disease, Parkinson’s disease and the prevention of strokes. With respect to Alzheimer’s disease studies have shown that patients with Alzheimer’s have much lower melatonin blood levels when compared to age matched normal controls. In ischemic stroke patients it was found that stroke patients had much lower melatonin levels when compared to normal age-matched controls. Other studies have shown that pineal gland calcification was associated with low melatonin levels and a high risk for ischemic stroke. This risk was even higher when the patients had high blood pressure, diabetes and high cholesterol/triglycerides. When a stroke has occurred, it is important that the free radicals are removed as quickly as possible, which is where the antioxidant properties of melatonin fit into a rehabilitative program. The presence of melatonin enhances brain plasticity. However instead of using melatonin after a stroke, it is much better to use melatonin regularly before a possible stroke, as this gives a better chance reducing the size of the stroke. This in turn will lead to a faster and more complete recovery after a stroke.

Another important disease of the elderly is Parkinson’s disease. Melatonin helps to prevent oxidative damage to the dopamine producing cells in the basal ganglia thus preventing Parkinson’s disease. As with Alzheimer’s disease, there is a correlation of low melatonin levels and this neurodegenerative disease, which goes beyond the age-related reduction of melatonin levels. In experimental Parkinson’s disease models in mice melatonin was highly effective in preventing deterioration of Parkinson’s disease.

4. Melatonin may extend life

The combination of being a free radical scavenger, an immunostimulant and an integral key hormone allow melatonin to have beneficial effects in the aging process. When melatonin supplements are given, the stimulation of the immune system can cut down infection rates in the elderly, prevent and mitigate degenerative diseases of the brain (Alzheimer’s, Parkinson’s), re-establish sleep/waking rhythms and help reduce arthritis.

Conclusion

Melatonin is a widely used sleep aid. As it is practically absent in people beyond the age of 55, it makes sense to supplement with melatonin in that patient group. However, there are side effects particularly in people on blood thinners as coumadin competes with melatonin in getting eliminated through the cytochrome P450 liver enzyme system. This will result in longer bleeding times in patients on blood thinners who also take melatonin supplements. It is important that patients discuss this with their doctors. However, given all of the benefits described above, for the vast majority of the baby boomers melatonin supplementation would be very beneficial. Doses as a sleep aid vary between 1mg and 5mg at bedtime for most people. Cancer patients require higher doses (10 to 20 mg per day).

More information on melatonin, which is at the center of the circadian hormone rhythm as the key hormone switching from day to night and welcoming the day by switching its secretion from the pineal gland off in the morning: https://www.askdrray.com/how-to-cope-with-time-switches/

Reference

1. Datis Kharrazian: “Why isn’t my brain working?” Copyright 2013, Elephant Press, Carlsbad, CA, USA (pages 306-310).

Last edited Nov. 7, 2014