Dear Dr. Blonz: What is the word on melatonin, a dietary supplement that is supposed to help with sleeping and sleep/wake patterns? Is it a reasonable supplement as a sleep aid? -- O.S., New York, New York
DEAR O.S.: Melatonin is a hormone produced by the pea-sized pineal gland that is located in the center of the brain. It is thought to be a key player in the control of the body's sleep/wake rhythms. The release of melatonin is stimulated by darkness and inhibited by light. The rationale behind taking melatonin supplements for a sleep disorder, such as jet lag, is that it can cajole the body into a more rapid shift to the light/dark cycle of a new time zone. There is some research to support this, but it is inconsistent at best. As a sleep aid, a meta-analysis in the Feb. 18, 2006, issue of the British Medical Journal reported that melatonin does not seem to be very effective for sleep disorders.
For most, there is little danger in trying melatonin, as most studies note an absence of adverse effects -- especially when small dosages (3 milligrams per day) and short-term use is involved. Keep in mind that you are taking a hormone normally produced by the body, so unless specifically instructed by your physician, this is not something you want to be taking on a regular basis.
Other sleep aids that can work include a warm glass of milk (flavored or not) before bedtime and/or a warm bath. Tryptophan is an amino acid that serves as the precursor to a neurotransmitter (a key brain chemical) called serotonin, which encourages relaxation. A metabolite of tryptophan, called 5-HTP, is also available, but again, I would not recommend using this product on a regular basis. Valerian is another herb that is also used to treat insomnia, but the evidence here is inconsistent at best. There is a good discussion of insomnia at the National Institutes of Health at tinyurl.com/7l99b4p.
I want to emphasize that the idea of a sleep aid is to get your sleep/wake rhythm back on track, not to have a pill become an essential part of your nighttime regimen. Be up-front with your physician to alert her or him to your sleep issues and avoid potential interactions between your sleep aid and any medications or health conditions.
Other approaches to consider: A good diet and regular exercise habits help with sleep. They not only help to decrease stress, which is a potent sleep robber, but exercise can help tweak the body toward a regular activity/regeneration cycle. There are a number of relaxation techniques and tapes that may be of help.
Send questions to: "On Nutrition," Ed Blonz, c/o Universal Uclick, 1130 Walnut St., Kansas City, MO, 64106. Send email inquiries to email@example.com. Due to the volume of mail, personal replies cannot be provided.