The Doctor is In

Q:Not sure if it’s related to stress, but I am having trouble falling asleep and staying asleep at night—is it safe to take melatonin every night? Is there something else I should be considering?

With a global pandemic, more isolation and financial strain for many, it is no wonder that insomnia is on the rise. Stress is a big risk factor for getting a good night’s sleep, and as those hours of rest elude us, we are often more groggy, more irritable and less productive. So what can be done?

Dietary supplements like melatonin can be helpful for some, but because these are not considered “drugs,” they do not go through the rigorous testing by the FDA for evidence of safety and efficacy. Although short term use of melatonin supplements appears to be safe for most people, information on long term safety of nightly use is lacking.

For most, this supplement tends to help people with falling asleep, but not staying asleep. Safety concerns could be possible allergic reactions, next-day fatigue and bad dreams.

Some melatonin products may not contain what is listed on the product label. A 2017 study tested 31 different melatonin supplements bought from grocery stores and pharmacies. For most of the supplements, the amount of melatonin in the product did not match what was listed on the bottle.

Melatonin is not recommended for pregnant or breast-feeding females, as well as those with a seizure disorder, autoimmune disorder or depression. It also may interact with other medications, so always speak to your physician before starting this supplement if you are on medications.

To get the most out of your own body’s melatonin, whose purpose is to put your body in a state of quiet wakefulness and promote sleep, it is best to keep the lights low before bed, and stop using your smartphone, tablet or computer at least 30 minutes before retiring. The blue and green light from these devices can neutralize the effect of melatonin, making it more difficult to fall asleep. Using a filter to screen out these wavelengths can be helpful if you must work on a screen at night.

In addition, to program your body to produce melatonin at the right time, it is important to get exposure to daylight during the morning and afternoon hours.

Other ways to help you with falling and staying asleep include decreasing caffeine after noon, getting plenty of aerobic exercise and minimizing daytime naps. Make sure your bed is comfortable, and try to stick to a schedule of falling asleep and waking up at the same time each day.

For those who wish to avoid medications or supplements, a proven solution for insomnia is cognitive behavioral therapy. CBT for insomnia is a short, structured and evidence-based approach where a trained provider focuses on exploring the connection between the way we think, the things we do and how we sleep.

Finally, it is important to speak to your health professional if you develop chronic insomnia. You could have underlying medical or psychiatric conditions that need to be addressed, or it may be related to medications or supplements that you currently take.

Either way, there is help for you, so here’s to getting more ZZZs in 2021.

Do you have a question you’d like to see answered by Dr. Damon Raskin in a future edition of the Post? Send it to mypost@palipost.com for consideration.