Insomnia is a sleeping disorder that affects more than half of the population. This is usually associated with the stress of our demanding lifestyles as well as shift work, jet lag, vision impairment, and neuro-disabilities (eg. autism) in certain patient groups such as paediatrics. Sleep deprivation can have a profound effect on quality of life. There is a wide range of treatments available that aim to assist with sleep, however, many of these treatments come with undesired side effects such as:
- persistent drowsiness the next morning,
- light-headedness,
- diarrhoea,
- dry mouth,
- nightmares,
- hallucinations,
- tolerance,
- and dependence.
These medications are usually only recommended for short-term use and are also not suitable for use in paediatrics.
The Sleep Hormone
Melatonin is an amino acid based hormone produced in a special part of our brain called the pineal gland. It helps to regulate other hormones and plays an important role in maintaining our body’s circadian rhythm. The circadian rhythm is also known as our body clock, an internal process which is critical for us to get a good quality sleep and to wake up refreshed.
Normally, melatonin levels begin to rise in the evening when darkness occurs to induce sleep and decrease in the morning allowing wakefulness during the day. However, production of melatonin in some people is low or out of sync, resulting in a variety of sleeping problems such as insomnia or delayed sleep phase.
One common miscomprehension which many people have is that melatonin is produced only when it is dark. This is only partly true. Its production is unique in that it’s optimal synthesis and secretion is predominantly at night between about 9p.m. and 8a.m., but only if these times are within the person’s recent sleep phase or cycle. That is, if a person’s recent sleep phase involved sleeping from 6a.m. to 2p.m. for the past few weeks and then there is a sudden change to sleeping from 9p.m. to 6a.m., then melatonin might not be produced or secreted since this is not the body does not recognise the new times as its sleep phase. A successful “phase shift” can takes many days. This is particularly a major issue for shift workers or people experiencing jet-lag.
The use of melatonin therapy 30 minutes before bedtime has been found to be safe and effective for the onset and maintenance of sleep. Though melatonin is readily available in most other countries, it is only available on prescription in Australia.