And why they stopped prescribing it for insomnia
My dear colleague, doctor-somnologist Alexander Kalinkin, the best sleep specialist in Russia, head Sleep Medicine Center university clinic of Moscow State University, says that they rarely resort to treatment of insomnia with melatonin. And that's why.
Melatonin was originally described as sleep hormone. The production of this hormone increases dramatically at dusk when the sun sets, peaks two hours after falling asleep, and decreases at about 5 in the morning.
Hormone of the night
But now it is absolutely certain that this not a sleep hormone, but a night hormone. It gives a signal to the body that night has come.
What is the difference?
As we know, at night our body goes into a completely different mode of operation. This is not only a change in respiration, blood pressure, but also a change in the activity of the genome, the production of protein and hormones. Some genes turn off, others turn on. The release of many hormones is clearly associated with sleep, even with specific sleep phases.
Melatonin is produced by a signal from the anterior part of the hypothalamus. This is our central biological clock, the main chimes. They receive information about the change of day and night and trigger the production of melatonin.
The task of this hormone is to convey to every cell of the body that it is necessary to switch to night mode. Moreover, the permeability of melatonin is amazing - it can pass through all membranes and act directly on the genome.
Melatonin is being studied very actively, there are even entire scientific journals devoted to it and evaluations of its use in various diseases.
And, although there is a lot of information, the data is very ambiguous.
It helps some people fall asleep, others do not.
What do we know about melatonin exactly?
That the young have a high total melatonin production, while the elderly do not.
Therefore, in some countries, melatonin is recommended for people over 55 years of age as the treatment of choice for insomnia. This is a long-acting drug, sold strictly by prescription. This is not something that is in any pharmacy or stores with dietary supplements.
There are attempts to use melatonin for various pathologies - strokes, ischemia, type 2 diabetes mellitus.
But at patients with type 1 diabetes mellitus its use is prohibited because it is an autoimmune disease, and melatonin is an immunomodulator.
Does this mean that it cannot be used for other autoimmune diseases - for example, thyroiditis?
The answer is, again, vague.
There is only a clear prohibition on type 1 diabetes mellitus.
We rarely use melatonin in our sleep laboratory.
Because today there are more than 80 different sleep pathologies, and with a high degree of probability, it simply will not help.
Definitely it can be recommend when jetlag, it is good for relieving jet lag.
Your Doctor Pavlova
Lack of sleep makes us an easy victim of the coronavirus
Do you need to sleep at least 8 hours? Not really
