Posted by Larry Hoover on April 25, 2005, at 9:45:44
In reply to Melatonin and sleep phase shift, posted by Cairo on April 23, 2005, at 7:34:18
> My daughter's neuropsych said she spoke with a friend who is a sleep study doctor at Cleveland Clinic who said that we might give melatonin a try in my daughter who has difficulty falling asleep. He said 1 in 3 respond well to melatonin.
>
> Dose? When to take it? All types equal? Safe for long term use? Nightly or not?
>
> Thanks!
>
> CairoYou have to experiment to find the dose that works. It is safe for long-term use, every night. It would be better, obviously, if you could figure out ways to manage the sleep-shift without any substances....
The problem with melatonin is that individuals vary substantially on the dose required. And, if you take too much, it is the same as if you take too little.....nothing happens. Melatonin does not have the common linear dose-response curve (i.e. low dose --> small effect, medium dose --> medium effect, high dose --> largest effect). Instead, if you saturate the melatonin receptors (too high an individual dose), the receptors shut down that night (the shut-down isn't permanent, it's just for that night).
I hope I haven't been confusing, to this point.
What you need to do is start at a very low dose, and work up until you find the effective dose. Some people don't absorb melatonin well. Others don't let it across the blood-brain barrier well. It's the dose that gets to the brain that matters.
Starting dose should be 0.3 to 0.6 miligrams. That's the physiological dose (the actual amount the brain should have in it). If you use a sublingual preparation, you bypass the stomach uptake issue, but it still may not pass into the brain efficiently.
If that isn't enough, increase the dose by about 0.5 miligrams at a time (that's just a rough number.....whatever you have that's close to that is a reasonable dose increase). I break the commonly found 3.0 mg pills into pieces, and just take the piece that seems to match the dose I want to take.
At some point, you're going to see a dramatic effect. That's the stable nightly dose. If you go past the effective dose, the effect will fall off. You need to find your daughter's unique effective dose. I know some people who need 6 mg or more. If I took that dose, nothing would happen. My effective dose is around 1.0 mg.
It is also best if you develop a stable routine. Taking the melatonin at the same time, every day, and going to bed at the same time. There's a little bit of fluctuation in how much "lead time" before bedtime to take the melatonin. 45 minutes works for me....some people need up to 2 hours, but I think those are extreme cases.
Lar
poster:Larry Hoover
thread:488272
URL: http://www.dr-bob.org/babble/alter/20050414/msgs/489185.html