Mind Matters -- August 2004
Written by Ron Sterling, M.D. and Published in Northwest Prime Time Magazine

Melatonin on My Mind
by Ron Sterling, M.D. -- August 2004

    Dear Dr. Ron:

      I am a 75 year-old man who had some sleep problems. Prescription medications for sleep were too strong. Relaxation techniques, alone, did not help. On the recommendation of a friend, I tried melatonin. It has been very helpful. However, I worry about the fact that there are so many different opinions about the use of melatonin. What is your opinion? -- Signed: Melatonin on My Mind.

    Dear Melatonin User:

      Thank you for writing! You are correct, there are many opinions about the use of melatonin. Although I cannot write about every aspect of melatonin in a short article, I can discuss the most significant issues and concerns.

      Discovered about 45 years ago, melatonin is a hormone that is produced in humans by our pea-sized pineal gland located in our brain just above the cerebellum. Melatonin is classified as a hormone because it has widespread effects in the body.

      Melatonin is released into our bloodstream during darkness. During daylight hours, melatonin levels are barely detectable. Light exposure to our retinas is transmitted to the pineal gland to switch it on or off. Even a brief exposure to bright light in the middle of the night can decrease the melatonin surge.

      Melatonin has effects on reproduction and sleep-wake cycles. For instance, in hamsters, the length of daylight reduces melatonin levels which then effect reproductive organs, stimulating such things as sperm production. Melatonin is used to artificially control seasonal reproduction in sheep and can increase the breeding cycle to two per year instead of just one. In humans, melatonin influences the timing and release of female reproductive hormones, affecting menstrual cycles, menarche, and menopause.

      Most studies have shown that melatonin production is high in children, falls during puberty, and then declines steadily with age and is barely detectable in older adults. About 50 percent of adults over 65 complain of sleep disorders. It has been postulated that a lower production of melatonin may be implicated in older adult sleep difficulties.

      A 2001 study showed that the sleep efficiency of people over age 50 who had a sleep disorder improved with doses of .1 mg, .3 mg and 3.0 mg of melatonin 30 minutes before bedtime. The .3mg dose was considered physiologic, since it elevated plasma melatonin levels only to normal. The 3.0 mg dose improved sleep but melatonin levels remained raised into the daylight hours of the next day (not normal for naturally-produced melatonin). Other studies have confirmed that melatonin is effective in promoting sleep initiation and sleep maintenance in older insomniac adults.

      It is likely that the most natural dosage of melatonin for sleep disturbances is .3 mg to 1.0 mg. Melatonin does not adversely affect the sleep patterns of people who have no sleep disorder. Similar doses have been used to study melatonin's effects on nocturnal blood pressure and on cognitive abilities in older adults. Those studies showed positive results reducing blood pressure by 5-10 mm Hg and increasing recall.

      Since it is a hormone with widespread effects, many doctors feel that the moderate positive effects of melatonin are not worth the risk of potential long-term side effects. However, there have been no documented long-term adverse effects. Ingesting melatonin does not appear to decrease the pineal gland's ability to produce melatonin on its own.

      It is my opinion that 1 mg of melatonin taken at night by people over the age of 55 will most likely benefit their wellness. I don't recommend long-term use in younger adults or children. The major benefit is the maintenance of a proper circadian rhythm which appears to have positive effects on sleep, blood pressure and cognitive abilities.

      I recommend that you discuss melatonin usage with your primary doctor before utilizing it. There are some potential side effects. For more information, please visit Aging Brain Web Page and scroll down to the section about melatonin. -- Best wishes, Dr. Ron.

        Author Bio:

        Ron Sterling, M.D. is a 64 year-old General and Geriatric Psychiatrist with a private practice in Seattle. He invites you to e-mail him at with any questions about mental wellness or emotional, relationship, or aging concerns. He is the only person who reads e-mail sent to Dr. Ron. Please be assured that your questions and identities are completely confidential and protected. Dr. Sterling has no financial interests or investments in any entities, whatsoever, that would benefit from the sale or distribution of melatonin products. For more information about Dr. Ron and for resources related to senior mental health, please go to SeniorMentalHealth.org. Read our Disclaimer. If you wish to understand more about Dr. Sterling's potential biases in health care advocacy, please check his Conflicts of Interest Disclosure Statement

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      Have a great day!

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