Can Melatonin Help with Insomnia? Insights from an Austin Sleep Therapist
Plenty of folks who can’t sleep turn to melatonin. Most people think of it as a sleep aid but they generally don’t find it effective for insomnia. An Austin sleep therapist break it down.
As a sleep therapist in Austin, a significant number of individuals seeking my help for sleep problems are either currently using melatonin or have tried it in the past. It's readily available in most stores that sell health products and is commonly perceived as a general sleep aid.
Understanding Your Natural Melatonin
It's important to understand that we all produce melatonin endogenously. Melatonin is a hormone synthesized by your pineal gland, primarily at night. Its main role is to regulate your sleep-wake cycle, which is part of your circadian rhythm. As darkness falls, your pineal gland increases melatonin production. This signals to the suprachiasmatic nucleus (SCN), a key area in your brain related to sleep, that it's approaching bedtime. Typically, you'll start to feel sleepy and fall asleep about two hours after this melatonin surge. Melatonin levels remain elevated throughout the night and then gradually decrease, dropping off about an hour after you naturally wake up.
Melatonin as a Chronobiotic, Not a Hypnotic
Many people use supplemental melatonin with the expectation that it will act as a hypnotic, similar to prescription sleep medications like Ambien and Lunesta, to "knock them out." However, melatonin is not a hypnotic. Instead, it's classified as a chronobiotic, meaning its primary function is to regulate or shift circadian rhythms, the internal biological clocks that govern our sleep-wake cycles. You can find more information about your circadian rhythm here.
It's also worth noting that the American Academy of Sleep Medicine (AASM) has issued an advisory regarding the use of melatonin in children and adolescents. You can find more details on this here.
Important Considerations for Melatonin Use
The Food and Drug Administration (FDA) classifies melatonin as a dietary supplement. This means it is not subject to the same rigorous regulatory oversight as pharmaceutical drugs, and consequently, the quality and accuracy of dosage can vary significantly between different brands and products. To increase your chances of purchasing a quality product, look for a "USP Verified" mark, which indicates that the product meets the standards of the US Pharmacopeial Convention. It is crucial to always consult with your doctor before adding melatonin to your medication regimen, as it is not recommended for everyone and can potentially interact with other medications you may be taking.
The American Academy of Sleep Medicine's Recommendation for Insomnia
The American Academy of Sleep Medicine (AASM) does not recommend the use of melatonin for the treatment of insomnia.
When Can Melatonin Be Helpful?
Melatonin is recommended for disorders in which timing is the main issue. A sleep therapist in Austin can tease out whether you have insomnia or a circadian rhythm issue.
Melatonin's primary utility lies in treating sleep disorders where the timing of sleep is the main issue. While timing can sometimes be a contributing factor in insomnia, it can usually be addressed effectively by stabilizing the individual's sleep schedule. However, Delayed Sleep-Wake Phase Disorder (DSWPD) can often present with symptoms that resemble insomnia, making it important to seek evaluation from a healthcare professional with expertise in sleep disorders.
So, for what specific conditions does the American Academy of Sleep Medicine recommend melatonin? Here are a few examples:
REM Sleep Behavior Disorder
Delayed Sleep-Wake Phase Disorder
Non-24-Hour Sleep-Wake Disorder
Shift Work Disorder
Jet Lag Disorder
The Gold Standard for Insomnia Treatment
It's essential to understand that the first-line and gold standard treatment for insomnia is Cognitive Behavioral Therapy for Insomnia (CBT-I). You can learn more about CBT-I here and schedule a consultation with a sleep therapist in Austin who offers CBT-I and other effective sleep therapies here.