DEAR DR. BLONZ: My boyfriend works at night and then takes melatonin to help him sleep during the day. For a number of weeks, he has been taking 3 milligrams a day. I told him that I wouldn't personally take it every day, but he said that otherwise he wouldn't get sufficient sleep. His job requires him to be alert, so getting enough sleep is crucial. I have looked up melatonin online but keep finding conflicting information. What do you recommend? -- J.K., San Jose, Calif.
DEAR J.K.: I question the use of melatonin on a regular basis for this purpose, especially if your boyfriend's work schedule is consistent. Melatonin should not be thought of as a sedative or a sleeping pill; it is more along the lines of a hormone that can facilitate "re-education" to reset your body to a new sleep schedule. Once the sleep pattern has been established, it has done its job. There are legitimate concerns about the taking of an unneeded hormone as a part of one's daily regimen.
Our bodies respond to daylight and darkness, and the hormone melatonin plays a role in the sleep/wake cycle. It is released by the pineal gland after we shut our eyes and go to sleep, which usually occurs at night in the dark. Seeing as your boyfriend is sleeping during the daylight hours, the room where he sleeps should be completely dark. If he routinely wakes during his "night" to visit the bathroom, that room should, if possible, be dark as well. When he wakes up at the end of his sleep, he should get some exposure to bright light. If there is no sunlight when he wakes for his "day," he might consider buying a full-spectrum light. The idea here is that he should do his best to educate his body that his pattern is the norm. When it is his sleep time he should avoid computer monitors, televisions, e-readers or tablets with bright screens, as this light can inhibit the body's normal melatonin production. (This is good advice for anyone having trouble getting to sleep.)
Your boyfriend should check with his physician to make sure that melatonin, or any other product, will not present a problem with his health profile. Thinking beyond medicinal fixes, eating well and exercising both help with sleep by decreasing stress, which is a potent sleep-robber. Exercise also helps tweak the body toward a regular activity/regeneration cycle, sleep being where regeneration takes place.
Other ideas: There are a number of relaxation techniques and tapes that may be of help. A warm glass of milk before bedtime is a tried-and-true remedy, as is a warm bath. Tryptophan, an amino acid, may also help -- it's the precursor to the neurotransmitter serotonin, which can encourage relaxation.
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