Melatonin, the whole story

Elsewhere on this site, we referred to a study from October, 2017 detailing the benefits of melatonin in promoting restful sleep. The Journal of the American Academy of Child and Adolescent Psychiatry confirmed that children with autism spectrum disorder (ASD) with refractory (stubbornly resistant) insomnia will benefit directly from prolonged-release melatonin. While the Hughes Brothers stand by our reporting of that study – with no commentary whatsoever – we offer you now some additional thinking on the subject.

For some children, melatonin has proven to be a miracle drug, of sorts. Key word: “drug.” Although melatonin is a naturally occurring hormone, it remains a powerful semi-sedative deserving of deep and abiding respect. Melatonin is sold as a natural supplement, and most doctors concur that occasional treatment with low-dose melatonin is probably safe.

Let’s just say that the whole matter of taking melatonin can be rather complex..

In the interests of absolute transparency, the Hughes Brothers must tell you that American Academy of Sleep Medicine does not recommend melatonin as a treatment for insomnia.

Make no mistake about melatonin.

Far beyond just swallowing a pill, the efficacy of melatonin depends on three considerations, any one of which can dilute or negate the results. In order then, these common melatonin-related mistakes.

The right dosage

Most melatonin supplements – laboratory produced, by the way – come over the counters in one, three, or five milligram tablets. Web-based sources can offer, however, a range of dosage from as low as three/tenths of a milligram to as high as twenty milligrams. The right dose will vary from person to person, but most research suggests that doses should be similar to the actual amount your body produces–something scientists call a physiologic dose. For most people, a physiologic dose lies very low, about four/tenths of a milligram of melatonin daily.

The problems arise when the daily dosage is too high. Excessive melatonin will make racking out of bed in the morning much more difficult. And, contrarily, high dosages may lower your body’s production of natural melatonin, thereby making the insomnia much worse over time.

So.

Work with your doctor to find the best amount of melatonin supplement for your child.

The right timing

Melatonin’s job is to prepare your child for a restful night of sleep. Ideally, the hormone would be ingested two to three hours before bedtime. At physiologic doses, melatonin should not make your child sleepy – unlike prescription sleep medications such as Ambien or Klonopin.

In those critical hours after taking melatonin, the body slows down, prepares itself for sleep

The Right Way

Swallowing a drug allows only a percentage of the active chemicals into the blood stream, therein exerting its influences. Drugs that allow only a small portion of the active ingredients into the blood are said to have a low oral bioavailability. Melatonin fits this description most certainly. Further, the ability to absorb melatonin again varies, again, from person to person. Some children might take up only ten percent of the active drug they’ve swallowed; other kids might absorb as much as fifty percent. It becomes a bit of a guessing game.

There’s a way though to manage a low dosage of melatonin: place the pill under your child’s tongue and wait for its dissolution. The hormone will then directly enter the blood stream through the capillaries in the child’s mouth. The dosage now becomes more predictable, more consistent.

Less is more.

Consult your doctor for an opinion on an appropriate dosage, remembering that a fully functioning pituitary gland produces about a half-milligram per day. The lower doses will likely deliver more happy results for your child with ASD. In fact, the whole family will sleep better.