Advanced Sleep Melatonin

Name: Advanced Sleep Melatonin

How should I take Advanced Sleep Melatonin (melatonin)?

When considering the use of herbal supplements, seek the advice of your doctor. You may also consider consulting a practitioner who is trained in the use of herbal/health supplements.

If you choose to use melatonin, use it as directed on the package or as directed by your doctor, pharmacist, or other healthcare provider. Do not use more of this product than is recommended on the label.

Use the lowest dose of melatonin when you first start taking this product.

Take melatonin at bedtime, or when you are getting ready for sleep. If you use this product to treat jet lag, take the melatonin at bedtime on the day you arrive at your destination and keep using this product for 2 to 5 days.

If you take this product to treat other conditions not related to sleep, follow your healthcare provider's instructions about when and how to take melatonin.

Do not crush, chew, or break an extended-release tablet. Swallow it whole.

Do not swallow the orally disintegrating tablet whole. Allow it to dissolve in your mouth without chewing. If desired, you may drink liquid to help swallow the dissolved tablet.

Measure liquid medicine with the dosing syringe provided, or with a special dose-measuring spoon or medicine cup. If you do not have a dose-measuring device, ask your pharmacist for one.

Call your doctor if the condition you are treating with melatonin does not improve, or if it gets worse while using this product.

Store at room temperature away from moisture and heat.

Melatonin Dosage

Melatonin is considered an effective treatment for jet lag and can aid sleep during times when you would not normally be awake.

Effective starting doses for jet lag range from 0.3 to 0.5 mg. One milligram tablets can be cut in half to achieve a 0.5 mg dose if smaller doses are not available for purchase. Lower doses may work for some people, while others may need a higher dose, up to 3 to 5 mg. However, higher doses may be associated with more side effects such as headache, next day grogginess, or vivid dreams.

Always start with the lowest melatonin dose. According to a Cochrane review, doses over 5 mg appear to be no more effective than lower doses. It is important to note that much higher doses are available for sale in the U.S., but these doses may result in excessively high levels of physiologic melatonin.

Other Uses for Melatonin

How to Take Melatonin for Sleep (Insomnia):

  • Dosage: Take melatonin 0.1 mg to 0.5 mg thirty minutes before bedtime. Studies suggest melatonin for sleep may be effective in promoting but not maintaining sleep (early morning awakening).

How to Take Melatonin for Shift-Work Sleep Disorders

  • Dosage: Take melatonin 1.8 mg to 3 mg thirty minutes prior to the desired onset of daytime sleep; melatonin may NOT lead to improved alertness during the nighttime work shift and may only improve daytime sleep time by about 30 minutes.

How to Take Melatonin for Delayed Sleep Phase Disorder

Delayed sleep phase disorder (DSPD) most often occurs in adolescents, possibly due to reduced melatonin production and melatonin deficiency at this age. Sleep onset is delayed by 3 to 6 hours compared with conventional bedtimes (10 to 11 pm). DSPD can negatively affect school performance, daily activities, and lead to morning drowsiness which can be dangerous for teen drivers. Any sleep disorder in an adolescent should be evaluated by a physician.

  • Dosage: Take melatonin 1 mg four to six hours before set bedtime. Once a set bedtime is achieved, use maintenance doses of 0.5 mg melatonin 2 hours before expected sleep onset. Bright light therapy and behavioral management may enhance results. Be aware drowsiness may occur after melatonin dose, so avoid hazardous activities such as driving.

How to Take Melatonin for Non-24-Hour Sleep Wake Disorder (Non-24)

More than 70% of people who are totally blind have Non-24, a circadian rhythm disorder. For people who are totally blind, there are no light cues to help reset the biological clock. The sleep time and wake up time of people who have Non-24-Hour Sleep Wake Disorder shifts a little later every day. Sleep times go in and out of alignment compared to a normal sleep-wake phase. Extra minutes add up each day by day and disrupt the normal wake-sleep pattern.

Use of melatonin in Non-24 is to aid in stimulation to reset the biological clock with one long sleep time at night and one long awake time during the day. However, no large-scale clinical trials of melatonin therapy for Non-24 have been conducted to date.

  • Dosage: Studies on the blind suggest that 0.5 mg/day melatonin is an effective dose.

Hetlioz, a prescription-only melatonin agonist is also approved for use in Non-24-Hour Sleep Wake Disorder in blind individuals.

  • Hetlioz (tasimelteon)

Fast-dissolving Melatonin

Some melatonin tablets are available in fast-dissolving formulations in the U.S. To take the orally disintegrating tablet:

  • Use dry hands to remove the tablet and place it in your mouth.
  • Do not swallow the tablet whole. Allow it to dissolve in your mouth without chewing. If desired, you may drink liquid to help swallow the dissolved tablet.

Call your doctor if the condition you are treating with melatonin does not improve, or if it gets worse while using this product.

Store at room temperature away from moisture and heat.

For More Information

  • Jet Lag Disorder Disease Reference
  • Jet Lag Health Guide
  • Melatonin Support Group
  • Sleep Disorders Support Group

History

Melatonin is one of the hormones produced by the pineal gland in all vertebrates. It is also produced in extrapineal organs, such as the eye, GI tract, bone, skin, lymphocytes, platelets, and thymus. 1 Early animal studies in the mid-1960s revealed its ability to affect sexual function, skin color, and other mammalian functions. It is a mediator of photo-induced antigonadotrophic activity in photoperiodic mammals, and it affects thermoregulation and locomotor activity rhythms in birds. It also has been implicated in time-keeping mechanisms in the pineal gland. Early studies showed that diurnal variations in estrogen secretion in rats could be regulated by changes in melatonin synthesis and release, induced by the daily cycle of light and dark via the efferent limb of the reflex in the sympathetic innervation of the pineal gland. Continual darkness depresses the estrous cycle. 2 , 3 In addition to being produced in vertebrates, melatonin is also found in plants, bacteria, unicellular eukaryotes, and invertebrates. 4

Melatonin secretion is inhibited by environmental light and stimulated by darkness, with secretion starting at 9 PM and peaking between 2 and 4 AM at approximately 200 pg/mL. The duration of melatonin production varies throughout the year with shorter periods occurring during the summer months and longer periods occurring during the winter months. 5 Nocturnal secretion of melatonin is highest in children and decreases with age. 6 , 7 Studies in the 1990s have led to widely expanded uses of melatonin including easing insomnia, combating jet lag, preventing pregnancy (in large doses), protecting cells from free-radical damage, boosting the immune system, preventing cancer, and extending life. 8

Although melatonin is not approved for marketing as a drug product, it has been classified as an orphan drug since November 1993 7 for the treatment of circadian rhythm sleep disorders in blind people with no light perception. It is commercially available as a nutritional supplement, either as a synthetic product or derived from animal pineal tissue. Use of the tissue-derived product is discouraged because of a risk of contamination or viral transmission. Most commercial brands are available as 300 mcg or 1.5 or 3 mg tablets under various names. Patients should seek medical advice before undertaking therapy.

Response and Effectiveness

Drowsiness may be experienced within 30 minutes of taking melatonin and generally persists for at least an hour. Supplements of 5mg increase peak melatonin levels by around 25 times; however, they do not alter the natural physiological release of melatonin. Plasma levels of melatonin return to normal within 24 hours of a single dose of melatonin.

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