SUPPLEMENT SPOTLIGHT
BY CARRIE ADKINS-ALI
Melatonin Misconceptions Before you recommend melatonin for sleepless patients, consider how it works Most people who have struggled with insomnia have had at least one health-care provider recommend melatonin. But this overthe-counter supplement isn’t a miracle med for all kinds of sleeplessness. Before you recommend it to your patients, consider what this hormone can—and can’t—do. Our bodies already make melatonin. Nestled in the center of the brain, the pineal gland communicates with receptors in the retina to let us know when it’s light or dark. When it senses darkness, it releases high levels of melatonin to prepare us for sleep. When it senses light, it shuts melatonin production down.
CONVENIENT CARE CLINICIAN
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Around age 40, the body begins to produce less melatonin, which can lead to age-related sleep problems. By age 90, melatonin levels are a mere 20% of what they were in the young adult years, notes Cinthya Pena-Orbea, MD, a sleep specialist at the Cleveland Clinic, Ohio. Melatonin Affects Sleep Onset Time Melatonin supplementation is far from a cure-all for insomnia. In fact, studies show that it may shave a mere seven or eight minutes off of the wait to fall asleep and lengthen sleep time by about the same amount. The American College of Physicians’ guidelines strongly recommend the use of cognitive behavioral therapy for insomnia (CBT-I) instead for simple insomnia. But sleep disorders other than simple insomnia are different. Because melatonin
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