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→Melatonin
=Melatonin=
=Melatonin=
Melatonin is a chronohypnotic that decreases firing rate of neurons in SCN via MT1 receptor, but only when endogenous levels are low (i.e. daytime). In older adults, the amount of MT synthesized and the number and affinity of MT1 receptors all decrease. Does not make you feel drowsy. It enhances natural sleep wake cycle. Must be paired with good sleep hygiene. Only need very small amounts (1 mg). Give 1 hr before bedtime. The body makes 1 mg per day, at higher doses exogenous melatonin might decrease your body's ability to synthesize it on its own. Higher doses in the short term show a dose dependent effect, but this wears off quickly and then melatonin stops working at all.
Melatonin is a chronohypnotic that is secreted by the pineal gland and decreases firing rate of neurons in SCN via MT1 receptor. Normal peak serum concentrations are 60 pg/ml. Less than 1 mg is synthesized per day. In older adults, the amount of MT synthesized and the number and affinity of MT1 receptors all decrease. Does not make you feel drowsy. It enhances natural sleep wake cycle. Must be paired with good sleep hygiene. Only need very small amounts (1 mg). Give 1 hr before bedtime. The body makes 1 mg per day, at higher doses exogenous melatonin might decrease your body's ability to synthesize it on its own. Higher doses in the short term show a dose dependent effect, but this wears off quickly and then melatonin stops working at all.
* Zhdanova IV, Wurtman RJ, Regan MM, Taylor JA, Shi JP, Leclair OU. Melatonin treatment for age-related insomnia. J Clin Endocrinol Metab. 2001 Oct;86(10):4727-30. doi: 10.1210/jcem.86.10.7901. PMID: 11600532.
* Zhdanova IV, Wurtman RJ, Regan MM, Taylor JA, Shi JP, Leclair OU. Melatonin treatment for age-related insomnia. J Clin Endocrinol Metab. 2001 Oct;86(10):4727-30. doi: 10.1210/jcem.86.10.7901. PMID: 11600532.
* Fatemeh G, Sajjad M, Niloufar R, Neda S, Leila S, Khadijeh M. Effect of melatonin supplementation on sleep quality: a systematic review and meta-analysis of randomized controlled trials. J Neurol. 2022 Jan;269(1):205-216. doi: 10.1007/s00415-020-10381-w. Epub 2021 Jan 8. PMID: 33417003.
* Fatemeh G, Sajjad M, Niloufar R, Neda S, Leila S, Khadijeh M. Effect of melatonin supplementation on sleep quality: a systematic review and meta-analysis of randomized controlled trials. J Neurol. 2022 Jan;269(1):205-216. doi: 10.1007/s00415-020-10381-w. Epub 2021 Jan 8. PMID: 33417003.
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** Systematic review and meta-analysis of 23 RCTs that used sleep quality as assessed by PSQI as an outcome. They found a significant improvement in sleep quality amongst patients with respiratory, metabolic, or sleep disorders, but not other comorbidities. Effects were seen for both low dose and high dose (>3 mg).
* Duffy JF, Wang W, Ronda JM, Czeisler CA. High dose melatonin increases sleep duration during nighttime and daytime sleep episodes in older adults. J Pineal Res. 2022 Aug;73(1):e12801. doi: 10.1111/jpi.12801. Epub 2022 May 13. PMID: 35436355; PMCID: PMC9288519.
* Duffy JF, Wang W, Ronda JM, Czeisler CA. High dose melatonin increases sleep duration during nighttime and daytime sleep episodes in older adults. J Pineal Res. 2022 Aug;73(1):e12801. doi: 10.1111/jpi.12801. Epub 2022 May 13. PMID: 35436355; PMCID: PMC9288519.
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