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Melatonin

A pineal hormone under the control of the biological clock located in the hypothalamus and regulated by light exposure.

The pineal gland  releases melatonin in picograms.

A pleiotrophic hormone that plays an important physiologic role.

It helps synchronize the body’s daily circadian rhythms with the light-dark cycle.

Levels of melatonin slowly increase a few hours before bedtime setting the stage for the body to switch to rest and other nighttime physiological activities

Endogenous melatonin regulates the sleep-wake cycle and other circadian rhythms.

Its secretion follows a diurnal patter.

Peaks 3 to 5 hours after sleep onset when it is dark.

There is almost no production during daylight.

Regulates circadian rhythms, mood and aging.

The production of melatonin, a sleep regulator, is inhibited by light and permitted by darkness as registered by photosensitive ganglion cells in the retina.

To some degree, the reverse is true for serotonin, which has been linked to mood disorders. 

Melatonin receptors are found in many issues, reflecting its effects on physiologic functions such as energy metabolism and body weight regulation.

A hormone found naturally in the body.

Commonly available in pill form, but melatonin is also available in forms that can be placed in the cheek or under the tongue, and allows the melatonin to be absorbed directly into the body.

Melatonin products are considered dietary supplements and have not been approved  by the FDA for any indication and their potency impurity are suspect.

People use melatonin to adjust the body’s internal clock.

It is used for jet lag, for adjusting sleep-wake cycles in people whose daily work schedule changes , and for helping blind people establish a day and night cycle.

Used for insomnia, delayed sleep phase syndrome (DSPS); rapid eye movement sleep behavior disorder (RBD); insomnia associated with attention deficit-hyperactivity disorder (ADHD); insomnia due to certain high blood pressure medications called beta-blockers; and sleep problems in children with developmental disorders including autism, cerebral palsy, and intellectual disabilities.

There is some evidence that delayed melatonin released in children with ADHD,  and some with the autism release melatonin at the wrong time of day.

Evidence success that melatonin reduces sleep onset delays in children with ADHD.

Used as a sleep aid after discontinuing the use of benzodiazepine drugs and to reduce the side effects of stopping smoking.

Up to 50% of normal children have sleep disturbances, which often decreases with age.

Up to 80% of children with attention deficit hyper activity disorder have sleep disturbances.

Use does not prevent delirium.

Some people use it for Alzheimer’s disease or memory loss (dementia), bipolar disorder, a lung disease called chronic obstructive pulmonary disease (COPD), insomnia caused by beta-blocker drugs, endometriosis, ringing in the ears, depression or seasonal affective disorder (SAD), mild mental impairment, nonalcoholic liver disease, chronic fatigue syndrome (CFS), fibromyalgia, restless leg syndrome, sarcoidosis, schizophrenia, migraine and other headaches, age-related vision loss, benign prostatic hyperplasia (BPH), irritable bowel syndrome (IBS), bone loss (osteoporosis), a movement disorder called tardive dyskinesia (TD), acid reflux disease, Helicobacter pylori (H. pylori), exercise performance, infertility, epilepsy, aging, for menopause, metabolic syndrome, for recovery after surgery, agitation caused by anesthesia, stress, involuntary movement disorder, postural tachycardia syndrome, delirium, inability to control urination, jaw pain, inflammatory bowel disease and for birth control.

May be involved in the development of neurodegenerative diseases including Alzheimer’s disease and Parkinson’s disease.

It is also used to calm people before they are given anesthesia for surgery.

Sometimes people apply melatonin to the skin to protect against sunburn.

Its main job in the body is to regulate night and day cycles or sleep-wake cycles.

Darkness causes the body to produce more melatonin, which signals the body to prepare for sleep.

Light decreases melatonin production and signals the body to prepare for being awake.

Some people who have trouble sleeping have low levels of melatonin. It is thought that adding melatonin from supplements might help them sleep.

Findings suggest it may reduce sleep latency and improve sleep duration, but randomized trials are inconclusive.

Meta-analysis does not support significant effects of melatonin on secondary sleep problems.

Reportedly alleviates anxiety and pain resulting from surgery, and reduces migraine attacks.

May improve cognitive function and and sleep maintenance in Alzheimer’s disease.

Has antioxidant and antiproliferative effects and may exhibit synergy with anticancer agents.

It is a scavenger of hydroxyl radicals

Associated with drowsiness, alterations in sleep patterns, altered mental status, disorientation, tachycardia, flushing, pruritus, abdominal cramps, headaches, trouble sleeping, bad dreams and hypothermia.

Potential consequences include glucoseintolerance and increase blood pressure and heart rate on patients currently taking melatonin and anti-hypertensive medications.

Concurrent administration with nifedipine may increase blood pressure and heart rate.

Higher doses may increase the risk of adverse effects.

Inhibits CYP1A2 activity.

Reduces levels of factor VIII and fibrinogen, and may increase bleeding when used with anticoagulants.

Melatonin products in the US are considered dietary supplements and are not approved by the FDA for any indication.
Melatonin dietary supplements potency and purity are suspect.
One  study that analyzed  31 melatonin supplements,  the melatonin content varied  from -83%-+478% of the labeled content, and varied buy as much is 465% of the same product in different lots.
No well controlled trial has demonstrated the efficacy of melatonin for treatment of insomnia in developmentally normal children.
Daily use of melatonin may improve sleep in children with autism spectrum disorder or attention deficit/hyperactivity disorder who have chronic insomnia.

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