Understanding melatonin, the body clock hormone

For almost 18 months melatonin has been available over the counter for older Australians, so is it worth investigating?

Melatonin is a hormone that helps regulate our circadian rhythms. It’s produced naturally by a small pea-like gland in the middle of our brains called the pineal gland.

As we get older we produce less of it, though any decline has probably taken place by the time we’re 60.

A lot of older people say they don’t sleep as long or as well as they used to, and lower melatonin levels could be a factor in that.

If you’re over 55 and struggling with sleep, you can talk to staff at your local pharmacy about getting a month’s supply of sustained release melatonin tablets (cost is $35). This is available without a prescription.

The dosage is 2 mg, the same as that used in a lot of the bigger studies on older people. It’s taken an hour or two before bed.

The product is called Circadin, and it’s designed for short-term treatment of ‘primary insomnia’, which means there’s no medical or other underlying cause for your sleep problem.

After that month you’ll need a prescription to keep using it. Stronger doses can be made by compounding pharmacies if your doctor prescribes it.

Melatonin is intended to help reset our sleep patterns. You might be aware that it’s also used to manage jet lag by getting our internal body clock back in synch.

Warnings about it usually include a reference to drowsiness, but doctors prefer it over benzodiazepines such as Valium, which are known to increase the risk of falling. Ideally, by resetting our body clock we’ll feel more alert in the morning.

It’s mostly well tolerated, and although other possible side-effects include nausea, dizziness and headaches, those seem to be rare.

Bear in mind that melatonin’s effect is lost if there are bright lights or noise in our environment. It won’t cut through those types of disruptions.

And drinking alcohol cancels the sustained release effect, leaving us with just a short burst.

So far so good, except there’s no evidence that it makes much difference to chronic insomnia.

It’s also not to be taken with a range of other medications that older people might be using, such as blood thinners, or some diabetes or blood pressure medications.

Melatonin aside, there are other sleep support supplements containing herbs such as valerian, hops or chamomile. Most of the major supplement lines have their own version.

Products containing magnesium and B6 are also sometimes recommended to help with sleep because they support the nervous system. One of these is a Bioceuticals product called Ultra Muscleze Night.

Everyone’s physiology is different, so if you’re doing all the right things to set yourself up for a good night’s sleep, but not getting it often enough, talk to your pharmacist, GP or naturopath about the options.

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