Something New in Melatonin?

You don't have to be a shift worker or jet setter to have awkward or non-existent sleeping habits, but both groups suffer quite a bit. Melatonin, one of the more popular over-the-counter supplements, may be headed toward a new delivery system, a patch placed on the body with small pulses of the hormone administered throughout the evening (or day), through your skin!

I've written about this sleep aid frequently because I get so many questions on it. Many supplement companies and health food stores will claim that melatonin is a natural sleeping aid or nightcap because it "naturally" helps regulate sleep-wake cycles. Given its wide spread availability today, you'd presume it's safe and effective.

Is it?

Well, that depends. Melatonin has been shown to help regulate sleep cycles in certain populations and really help out quite a few people, but like anything there are pros and cons:

• The precise mechanism of melatonin secretion in the body is not well understood. We do know, however, that melatonin isn't just about sleep-wake cycles. It's been shown to help regulate the female reproductive cycle and may also affect the onset of puberty. Children who take melatonin can suffer a delay in sexual development. (So never ever give a child a melatonin supplement.)


• This new patch study showed that men and women had different levels of melatonin in their system with the same dosage patch! So a gender difference may apply.


• Studies have pointed to melatonin's role in regulating blood flow, specifically in constricting coronary arteries.


• And it's been suggested that melatonin can increase depression in people prone to the illness.

For the record, melatonin is a hormone, and it's not a regulated drug under the FDA. No other hormone is available in the United States without a prescription. In some parts of Europe, melatonin is available by prescription only.

If this experimental patch version of melatonin reaches the market, it could have a much bigger effect on the body than just popping a pill. The half-life of a melatonin pill is short and it doesn't last long; a patch, on the other hand, can deliver small doses throughout its use to keep the levels in the body consistent for a longer, stronger effect. This might be great for shift workers who sleep during the day, when the body does not like to produce melatonin.

The patch has been tested on people who sleep during daylight hours and work at night.. For this reason, I can see why a melatonin patch could be helpful to those who maintain schedules opposite to the usual solar day (where the body prefers to be functional). And I have great respect for those who manage to live this life for the sake of their careers and my safety (e.g., emergency care, pilots, etc.). But, even though the patch would be sold as a prescription, it wouldn't surprise me to see people getting their hands on it without trying other sleep hygiene tactics first, which can be far more effective and healthier overall for the body, particularly for those of us that can really get our shut-eye at night.

Sweet Dreams,

Michael J. Breus, PhD, FAASM
The Sleep Doctor™

This article on sleep and melatonin is also available at Dr. Breus' official blog, The Insomnia Blog.

Related Topics:

• WebMD Video: Melatonin - How It Affects Sleep
• Sleep Disorders: Member Discussion
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Trouble Keeping Up with Your CPAP?

It's widely known in sleep medicine circles that the most common - and helpful - treatment we have these days for patients with Obstructive Sleep Apnea (OSA) is the CPAP machine, short for Continuous Positive Airway Pressure. If you've been diagnosed with OSA, then you know exactly what I mean.

The problem with CPAP therapy is that not a lot of people are good about using it on a routine basis. Or, like trying to start a ambitious exercise program, they are compliant at the start and then slowly drop off. Within a few months, they are rarely found using their CPAP. And sleeping poorly as a result.

But there's hope: new research that just surfaced and was presented last week at a conference in San Diego has revealed that when patients are prescribed just a two-week course of a certain sleep aid (the one marketed as Lunesta), they are more apt to be using their CPAP in six months.

Lunesta is one of the more popular prescribed sleep aids, which can help you to fall asleep and stay asleep by enhancing the activity of a sleep-friendly chemical called gamma-aminobutyric acid (GABA). My guess and experience is that many of the sleep aids in this category would work as well.

So I ask you:

• Do you have OSA?


• Do you have a CPAP collecting dust in your closet or beside table?


• Are you tired of being tired?


• Have you ever heard about apnea and how it can affect your health and relationship?

If you answered yes (and I know there are a lot of you out there) then you may want to take up this conversation with your doctor. Using a sleep aid for a short period of time in conjunction with a CPAP appears to be able to help you set an important pattern in your nightly routine. You'll get used to using the CPAP, and feel the difference a good night's sleep brings.

I know, the CPAP isn't the sexiest of devices, especially for a bedroom. But it can transform an OSA-sufferer's sleep. OSA is associated with some pretty unwanted health consequences - from heart problems to mood and memory problems, and even weight issues. Yet there's no consequence to using a CPAP machine other than better sleep, better health...and a happier bed partner who doesn't have to listen to your episodic breathing (and probably snoring) all night.

It's time to put OSA to bed.

Sweet Dreams,

Michael J. Breus, PhD, FAASM
The Sleep Doctor

This article about Obstructive Sleep Apnea is also available at Dr. Breus's official blog, The Insomnia Blog.

Related Topics:

• Sleep Apnea Health Center
• Sinus, Snoring, Sleep Apnea: Jordan S. Josephson, MD
• Sleep Disorders: Member Discussion
• Get the Sleep Well newsletter in your inbox weekly

Make Money in Your Sleep

Now this is pretty funny. Depending on how you look at it.

Earlier this month Steve Martin appeared on David Letterman talking about his experience with a sleep aid (you can go here to view the actual clip). An avid online poker fan, Mr. Martin found himself playing late one night, going to sleep after taking a sleep aid, and then waking the next morning to find new winnings in his online poker account. He'd gone to bed with $500 in his account and discovered that the same account was worth $1,500 the next day.

He thought there had been a glitch in the system. He thought there had been a mistake. But no, there wasn't a glitch or a mistake. When Mr. Martin called to check with the people behind the online poker game, he was told that he'd in fact won that extra $1,000 while playing between 4 am and 5 am.

Needless to say, Mr. Martin had no recollection of getting up, getting online, and playing poker in the middle of his sleep. The experienced freaked him out enough that he stopped using the sleep aid.

Is this the norm?

Far from it. Sleep aids are some of the most widely prescribed medications in America, and it's rare to have such a bizarre reaction to these drugs. Reports have emerged about strange side-effects like sleepwalking, sleep talking, driving, eating, and performing tasks while supposedly in your sleep. But again, these side-effects are extremely rare.

It's not known whether Steve Martin's mid-sleep poker playing (and win) was related to his taking a sleep aid. But his experience marks the first time someone has come out and blamed a sleep aid on winning money from playing poker during sleep.

This gives new meaning to "making money in your sleep," doesn't it? Good thing he posted winnings that night. What if he'd gone online and unknowingly blown away thousands of dollars? He'd probably call his lawyer.

Sweet Dreams,

The Sleep Doctor
Michael J. Breus, PhD

This article by The Sleep Doctor is also available at Dr. Breus's official blog, The Insomnia Blog.

Related Topics:

• Sleeping Pills: What Consumers Need to Know
• Understanding the Side Effects of Sleeping Pills
• Get the Sleep Well newsletter in your inbox weekly

Cheaper Sleep Medications?

Guess what? The time has actually come for the patent of one of the most widely used sleep medications in the world -- Ambien -- to come to an end. According to a recent article in The Sleep Report:

This year alone, 10 brand-name medications with revenue exceeding $8.1 billion are expected to lose patent exclusivity, including the widely prescribed sleep medication Ambien (zolpidem tartrate).

• Ambien's US sales exceeded $2 billion last year.


• Medications to treat sleep disorders are one of the fastest growing categories of drug spending, rising 31.5% in 2005 alone according to Medco Health Solutions Inc, a pharmacy benefit manager.


• While seniors use the most hypnotics, younger adults showed the greatest increase in use of these drugs.


• According to Medco's analysis, the number of adults aged 20 to 44 years using sleeping medications increased by 128% between 2000 and 2005.


• According to pharmacy market analyst IMS Health, a one percent increase in generic utilization nationwide yields almost $4 billion in savings.

So what does this mean for those of you who are taking these valuable medications?

First, you should know that the makers of Ambien have done a great job of reducing the price of their newest medication, Ambien CR, so that it will match or come very close to the price of generic.

Next, I hope to see insurance companies recognizing that the use of these medications can in fact LOWER our healthcare premiums, but I doubt it.

Related Topics:

• To Sleep, Perchance to Sleep Soundly
• WebMD Video: Sleeping Pills

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