Sleep: Timing of Melatonin, Light, Dark, & Use of Other Aids

When to take Melatonin, how much, and whether to take the quick-release or the extended-release form can be a confusing issue.

Since sleep is so critical to the health of body and brain, we have accumulated some "tricks-of-the-trade" covering proper melatonin usage as well as other effective aids.

Here is information gathered from parents and doctors to help clear up some of that confusion about what to take and/or do, and when.

As with any suggestions, these are things parents have found helpful for their own children. Consult with your own child's doctor before implementing.

To get to sleep, most of our children do fine taking 1-3 mg melatonin half-an-hour to an hour before bed.

Some children with difficulty remaining asleep take 1-3 mg extended/sustained release melatonin right at bedtime.

Some parents report giving children with both issues a combination of immediate-release and sustained-released melatonin.

Other children do better with melatonin precursors such as L-Tryptophan or 5-hydroxytryptophan (5-HTP). Some additionally use the amino acid brain neurotransmitter Gamma-aminobutyric acid (GABA), along with inositol & niacinamide. GABA is known to induce relaxation and improve restful sleep. One indication for the use of GABA may be tense or achy muscles. Some alternate GABA with, or add, Valerian root. Sometimes they use these in addition to the melatonin.

One of the most obscure but critical facts about melatonin use is in the disorder of circadian rhythm. In this disorder, melatonin is given 5-6 HOURS before bed!

Here is one case:

The daughter was taking a large quantity (over 6mg) combination of extended-release and regular melatonin, tryptophan, and other supplements were tried, yet she was still having trouble sleeping at night and waking in the morning. Three sleep specialists later, one finally understood the problem was circadian rhythm disorder (a sleep study was NOT required to diagnose this condition). The specialist had her switch the timing and dosage of the melatonin.

Melatonin can be sedating, so a lesser amount was prescribed 5 hours prior to bed.
In addition, light therapy, which was being used, was switched to earlier in the morning, more intensely (closer distance at 10,000 lux), and for a briefer period of time.

It should be noted that others have reported that in addition to the light therapy in the morning, and melatonin either used at bedtime or 5-6 hours before bedtime, DARKNESS at night is equally critical.

For darkness, it has been suggested that if at all possible, the room should be so dark that a person cannot even see his/her own hand. This goes against our parental instinct to provide night lights. It is a judgement call, of course. I certainly would not wish to traumatize a child. I have not heard from a parent trying this, but perhaps a sleep mask over the eyes, if the child would tolerate one, might be useful?

Another suggestion is applying the research stating that dark AMBER or ORANGE sunglasses that the blue portion of the light spectrum (short light wavelengths), worn while awake at night (starting at about 5 or 6pm) can also help re-set the circadian clock, or help prevent it from going awry: See: Blue blocker glasses impede the capacity of bright light to suppress melatonin production and Dark therapy for bipolar disorder using amber lenses for blue light blockade.

Dr. Jim Phelps of PsychEducation.org and the Corvallis Psychiatric Clinic believes dark therapy can be beneficial in treating rapid cycling, and other symptoms of bipolar disorder.

In the article, Keeping bipolar disorder in the dark may just do the trick suggests that since the length of time in darkness-14 hours each night is not do-able, the dark amber sunglasses used in conjunction with the blacked-out room to sleep in, might do the trick.

1000mg L-Tryptophan has been as helpful for my daughter in promoting undisturbed sleep--eliminating horrific nightmares--as 150mg Seroquel/quetiapine (500mg Tryptophan per 75 mg Seroquel was suggested by her M.D. specializing in Integrative medicine).

And many parents love the way some homeopathic remedies, such as Hyland's Calms and Hyland's Calms Forté™, work for helping their children sleep better.

In summary, suggestions to consider--depending upon problems-- are:

• Small dose melatonin 5-6 hours prior to bed for circadian rhythm disorder
• Fast-release melatonin right before bed for help getting to sleep
• 6 hr. extended-release melatonin for trouble staying asleep
• L-Tryptophan
• 5-hydroxytryptophan (5-HTP)
• Hyland's Calms or Hyland's Calms Forté™
• GABA with inositol & niacinamide
• Valerian root
• NutraSleep™ (by Source Naturals) has GABA, inositol, Valerian root and a few other helpful natural sleep components.
• Light therapy early in the morning
• Dark bedroom for sleep or use eye mask
• Dark Amber sunglasses in the evening
• Dark therapy (for 14 hours) at night

Other suggestions for helping sleep include:

• Have a white noise source on at night
• Cool room, warm feet
• Avoid sugary or refined-grain bedtime snacks which can cause a blood-sugar drop during the night (which can in turn cause disturbed sleep or waking up)
• Avoid caffeine
• No TV, computer use, or homework within an hour (or 2) of bedtime
• Have the child checked for food sensitivities and eliminate those foods
• Regular exercise
• Strict sleep/wake schedule applied every day. Don't vary it on weekends and vacation days.
  

In addition, consider having a sleep study done, and using pharmaceutical interventions when necessary. Some children may have sleep disorders requiring the use of pharmaceutical medications such as the daytime use of provigil/modafinl, nuvigil/Armodafinil, Wellbutrin, etc, or nighttime use of medications targeting sleep architecture (such as Xyrem) in the case of severe narcolepsy or related disorders.

Another consideration is that either low or high hormone levels can cause excessive sleep, disturbed sleep, erratic sleep cycles, or diminished sleep.


Amber glasses - blue-light blocker sunglasses product recommended to me by people like YOU: BluBlocker


Additional Reading:

• Sleep: A Critical Yet Under-addressed Component of Health
• Abnormal Sleep as a Cause of Mental Symptoms
• Hard-to-Find but Commonly Needed Hypoallergenic Supplements
• Managing Symptoms Vs Treating Illness
• Inflammation of Body and Brain
• Sets of Symptoms--Not the Cause–Get Diagnostic Labels
• Musings on “Medical Mysteries”

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Last Updated: 13 March 2009