Melatonin:

 Melatonin is a hormone secreted by the pineal gland during sleep. Melatonin production declines as we age. Melatonin's main use has been shown to regulate sleep and allow the individual to feel more refreshed and alert the following day.

 As melatonin is directly involved with sleep regulation, it is effective in the treatment of jet lag and sleep loss during shift work.  Melatonin has also been shown to improve Seasonal Affective Disorder and extend the life span of animals. Melatonin is even considered to be a potent antioxidant.

 Melatonin has been touted as a cure for everything from cancer to insomnia, and sales of melatonin now exceed those of vitamin C in the United States. Since family physicians are likely to encounter patients taking melatonin, they need to be familiar with the possible benefits and dangers of this agent.

Melatonin and Sleep Disturbances:

 INSOMNIA

 Melatonin is a hormone secreted at night by the pineal gland. It is important in regulating sleep and, possibly, circadian rhythm. Melatonin secretion decreases with age, and this decrease has been associated with sleep disturbances in the elderly. Because melatonin's half-life is only 35 to 50 minutes, sustained-release formulations as well as immediate-release formulations have been studied in the treatment of insomnia in the geriatric population.

One study in elderly insomniacs with significantly lower melatonin levels than those in elderly patients without sleep disturbances showed that a sustained-release preparation improved sleep maintenance (sleep as a percentage of time in bed and activity during sleep), while an immediate-release preparation decreased sleep latency (time required to fall asleep).

 In a double-blind, placebo-controlled, crossover study of 12 melatonin-deficient elderly subjects who complained of long-term insomnia, 2 mg of controlled-release melatonin, taken two hours before bedtime, improved sleep efficiency (sleep time as a percentage of time in bed) and decreased nocturnal awakenings. Melatonin was not found to decrease sleep latency or to increase total sleep time (time actually spent asleep).

 MELATONIN USE:

Take Melatonin by mouth generally 2 hours before bedtime. Results may be seen within 30 minutes. Follow all directions on the product package. If you are uncertain about any of the information, consult your doctor or pharmacist. Full benefit is usually seen after 1 to 3 days of use. If your condition persists or worsens or if you think you may have a serious medical problem, seek immediate medical attention.

 MELATONIN  SIDE EFFECTS:

 Headache or altered sleep pattern may occur. If either of these effects persists or worsens, contact your doctor promptly. Unlikely but report promptly: mental or mood changes, itching, fast heartbeat, sensation of heaviness in the head. If you notice other effects not listed above, contact your doctor or pharmacist.

 Should certain people avoid it?

 1) Yes. "Those include women who are pregnant or nursing (since no one knows   how excessive exposure to the hormone might affect a fetus or infant); people with severe allergies or autoimmune diseases (melatonin could exacerbate such conditions by stimulating the immune system); people with immune-system cancers such as lymphoma or leukemia (for the same reason), and healthy children (who already produce it in abundance). Women trying to conceive should also think twice about taking the hormone, since high doses can act as a contraceptive." As with any substance introduced into your body, if you have a medical condition you should always consult your physician first before taking melatonin.

 2) If you are having surgery, notify your doctors you are taking this herbal product.