Melatonin - New Info on Dangers, Dosage andPatient Selection

[Therapist]

A great video segment - http://www.doctoroz.com/episode/why-mel ... your-sleep

I often make fun of Dr. Oz but watch this and you will see this is Dr. Breus correcting some of the things Dr. Oz has said in the past.

What do you think?

I tried larger doses briefly some few years ago and was not happy with the results. I am ordering some 0.5 mg tablets today.

[carbonman]

What do you think?

I saw that show last night.
These people are using melatonin like a sleeping pill.
They had no idea how it works. Shame on them.
Next...shame on Dr. Oz and Breus for not addressing
the initial question of "Why are you having problems
sleeping to begin with?"
I would wager a guess that most of those women have OSA.
I tried melatonin before I was diagnosed w/OSA
and guess what....it did not work.
I am a Dr. Oz fan......BUT......
I thought is was a very uninformative and misleading show.

[ems]

You can be sure that next year an article will appear that says anyone over 50 should take 100 mgs every nite.

[chunkyfrog]

Dr Oz is like Oprah--looks to be on your side; but sold out years ago.

[Posey]

Some years ago I needed bilateral knee replacement. After surgery, I needed help sleeping & Melatonin was suggested. I use a product from- the GNC store 1 mg. sub-lingual Melatonin. Now I only use them perhaps once a month or less. I pop it under my tongue & within 10-30 minutes I am ready to doze off. If I wake again in the night, which I usually do, I do NOT take another. It always helps to understand how and what a drug - even a "natural " one is doing to you.
They work for me as an occasional assist.

I quit watching Dr Oz after it became clear that it was just a long commercial.

[lazer]

I think the current Melatonin supplement I use contains 5mg, I guess I am in danger now?

Haven't had the time to have read up on the article yet.

[ChicagoGranny]

"Why are you having problems
sleeping to begin with?"
I would wager a guess that most of those women have OSA.

Someone used to regularly post here that "90% of sleep problems are caused by OSA".

I wonder if that is true?

[ChicagoGranny]

I think the current Melatonin supplement I use contains 5mg, I guess I am in danger now?

Haven't had the time to have read up on the article yet.

Anyone who is taking that much or anyone who is under 50 and taking it needs to view the video.

Except for older people most bodies produce enough melatonin. If your body is producing enough melatonin taking supplements is counterproductive. The exception would be very short term use of melatonin in order to shift the sleep clock due to jet lag or changes in shift work.

If your body is not producing enough melatonin due to aging or a health abnormality, very small doses of 0.5 mg may be helpful.

Taking more than this can cause "hangover" including headache and dizziness.

Lazer, After you view the video it would be interesting to hear your comments about your situation. I will consider taking 0.5 mg at my 3:00 a.m. awakenings.

[lazer]

I think the current Melatonin supplement I use contains 5mg, I guess I am in danger now?

Haven't had the time to have read up on the article yet.

Anyone who is taking that much or anyone who is under 50 and taking it needs to view the video.

Except for older people most bodies produce enough melatonin. If your body is producing enough melatonin taking supplements is counterproductive. The exception would be very short term use of melatonin in order to shift the sleep clock due to jet lag or changes in shift work.

If your body is not producing enough melatonin due to aging or a health abnormality, very small doses of 0.5 mg may be helpful.

Taking more than this can cause "hangover" including headache and dizziness.

Lazer, After you view the video it would be interesting to hear your comments about your situation. I will consider taking 0.5 mg at my 3:00 a.m. awakenings.

I will certainly watch the video later when at home. Right now, I do know that the Melatonin has greatly helped me in getting to sleep. I've sampled several different supplements all containing about the same mg stated. I also take a 1mg clonazepam at night ( 2x more during the day) and one of my Gabepentin doses 300 mg at night along with a Risperdone. This current "cocktail" seems to be working for me but maybe the video will make me pull away from the Melatonin and either see how things go and/or revisit the 5-Http which once proved useful for the same purpose.

[ChicagoGranny]

I also take a 1mg clonazepam at night ( 2x more during the day) and one of my Gabepentin doses 300 mg at night along with a Risperdone. This current "cocktail" seems to be working for me but maybe the video will make me pull away from the Melatonin and either see how things go and/or revisit the 5-Http which once proved useful for the same purpose.

That is quite a potpourri of powerful stuff. Were you diagnosed with SDB only this year? Maybe SDB is the root cause of some or all of the problems the cocktail is trying to address? If your CPAP therapy is working well maybe you can begin to drawdown the cocktail?

Good luck,

[old64mb]

Finally.

I've argued in the past about this - there was a presentation a few years back by one of the Stanford sleep fellows on melatonin that simply shocked me since he looked at plasma concentrations and came up with the same conclusion - somewhere between 0.25 to 0.5 mg to start, and maybe 1 mg if that doesn't work. At the time, I couldn't find anything else out there on dosing and titration and was just stunned at how badly people were overdosing.

For circadian rhythm issues it can be useful, but at doses people have been taking on this board (and elsewhere) it is something that is long overdue to be looked at.

[lazer]

I also take a 1mg clonazepam at night ( 2x more during the day) and one of my Gabepentin doses 300 mg at night along with a Risperdone. This current "cocktail" seems to be working for me but maybe the video will make me pull away from the Melatonin and either see how things go and/or revisit the 5-Http which once proved useful for the same purpose.

That is quite a potpourri of powerful stuff. Were you diagnosed with SDB only this year? Maybe SDB is the root cause of some or all of the problems the cocktail is trying to address? If your CPAP therapy is working well maybe you can begin to drawdown the cocktail?

Good luck,

Actually it was originally 6+ years ago when I had my only (in-lab) sleep study that my PCP suspected SDB but it was never proven then. Since, I've been on a varying mix of meds for depression, anxiety, and insomnia. Most recently got the xanax switched to the Clonazepam in an effort to stop / step down from the benzos. (at least this is what my psychiatrist confirmed to me would be a good step when I told him I wanted off the xanax). So far, I still seem to need at least part of the cocktail to get to sleep at night as the one time I recently missed due to some short term memory loss and forgetting to take ANY of my night time pills, I ended up laying away from 10pm to 3am and then couldn't figure out why until the next morning when I checked my pill container that my pills for that night were still there

I'm still trying to find some quiet time to be able to watch and concentrate on the video as per the OP.

[ChicagoGranny]

Lazer, Have you established a regular routine of exercise, good diet and good sleep hygiene?

These may seem like common sense but only when I joined here and kept reading posts about these three did it begin to dawn on me how critical they are to good health. CPAP alone won't do it for me.

[lazer]

Lazer, Have you established a regular routine of exercise, good diet and good sleep hygiene?

These may seem like common sense but only when I joined here and kept reading posts about these three did it begin to dawn on me how critical they are to good health. CPAP alone won't do it for me.

Exercise admittedly I'm lacking in. I work a sedentary job and seem to have too much going on in my schedule to work that part in even though I have a stationary bike in my living room collecting dust & recently purchased an 18 speed mountain bike at the flea market in hopes of getting out more and enjoying bike riding naturally (although the weather/season change here in PA is going to shoot that down... )

My diet I would classify as good. I'm generally still low-carbing and maintaining a normal BMI.

Sleep Hygiene for the most part is fair to good. Sometimes I am guilty of watching some TV whilst in bed or plunking away on my android tablet browsing the forums and such but for 80% of the week, it's Zeo / mask / lights out, and I'm asleep within 30 minutes - depending on how late I took the Melatonin as this still is what I presume clearly knocks me out.

Relationship stress has been playing a MAJOR factor in my life as of late though.

[robysue]

Exercise admittedly I'm lacking in. I work a sedentary job and seem to have too much going on in my schedule to work that part in even though I have a stationary bike in my living room collecting dust

Is there a TV in your living room? If so, then you can kill two birds with one stone: Do your TV watching in the living room while riding the stationary bike instead of retiring to the bed room to watch the TV.

The toughest thing about exercise is simply starting it. We all think we're too busy to do it. (I'm guilty of this too at times.) But if there's a stationary bike in the living room and a tv in the living room .... well, it doesn't take a rocket scientist to figure out that if you're going to spend 30 minutes watching tv anyway, it would be more productively spent watching the tv while pedaling that stationary bike.

& recently purchased an 18 speed mountain bike at the flea market in hopes of getting out more and enjoying bike riding naturally (although the weather/season change here in PA is going to shoot that down... )

If that bike is ready to ride, give yourself a chance to ride it before the snow flies. Start small---take it for a spin around the block (or the equivalent if you live in the country) some evening after you get home and before you start making dinner---in other words, go for a five minute spin on the mountain bike when you get home. If you enjoy biking, you'll soon be making time to bike rather than finding excuses to not get on the bike. (Me? Having not been able to bike since late June due to the broken left pinky, I'm now beginning to nag hubby to get a bike into riding shape for me so that I can do some biking before the snow flies here in Buffalo.)

Sleep Hygiene for the most part is fair to good. Sometimes I am guilty of watching some TV whilst in bed or plunking away on my android tablet browsing the forums and such but for 80% of the week, it's Zeo / mask / lights out, and I'm asleep within 30 minutes - depending on how late I took the Melatonin as this still is what I presume clearly knocks me out.

Work on that sleep hygiene. Aim for getting it into the "good to excellent" range rather than settling for "fair". Yes, it's hard. But the only way you're ever going to be able to get off some of that drug cocktail you're using every night to get to sleep is to have excellent sleep hygiene.

Besides: It's counterproductive to spend time in bed watching TV or plunking away on the android tablet burning up the melatonin your body is trying to make and also taking a megadose of melatonin in an effort to get to sleep. As the Dr. Oz show points out----melatonin regulates the sleep cycle, it does not allow one to fall asleep faster than one normally would. And you're harming your body's ability to self regulate the sleep cycles by burning up melatonin whenever you watch TV or get on the Android tablet while in bed.

And have you recently looked at the known side affects of the prescription drugs in your cocktail? Directly off the [url=http://www.nlm.nih.gov/medlineplus/druginformation.html]Medline Plus site[url], which is run by the US NIH, are the following (common) side effects for:

clonazepam: drowsiness
Gabepentin: drowsiness
Risperdone: drowsiness, dreaming more than usual, difficulty falling asleep or staying asleep

It could well be that it's this combination of drugs that's "knocking you out" for the night instead of the melatonin. And the Risperdone/melatonin megadose combination might be why your zeo is showing so much REM time and so little DEEP sleep time.

If I were in your shoes, I'd do a little week long experiment: I'd cut the melatonin out completely for a week, but take the other things on time. And I'd see if there was any difference at all in that 30 minute latency to sleep on the nights where my sleep hygiene was good (no TV or android tablet in bed; going to bed when I felt sleepy instead of based on the clock time; making sure the bedroom is quiet, cool, and dark; and NO watching the clock if you think it's taking too long to get to sleep----just get out of bed instead and wait for the sleepies to come).

Relationship stress has been playing a MAJOR factor in my life as of late though.

And relationship stress is likely making it harder to get closure for the day at the end of the day. That's a tough nut to crack. But working on consciously letting go of the stress and the worrying about the relationship at the end of the day is important. Don't just use the TV or android to mask the need for closure at the end of the day: When you go to bed, the relationship stuff is what it is for that day and you can't go back and change things in the past. And while relationships take time and effort and hard work, it's not productive to worry about what you need to do in the future to "fix" the relationship problems when you are trying to get to sleep. If you can't let go of the relationship woes at bedtime, you may want to get on that stationary bike and try to burn off some of the negative energy in a more positive way.

Best of luck