Levels of melatonin decrease as we get older but these levels are often even lower in patients with Alzheimer’s disease (AD).
As well, those with AD are more prone to sleep disturbances, including difficulty falling asleep, waking up more frequently, and staying awake for longer periods during the night. ‘Sundowning’ symptoms can present, including disorientation, pacing, anxiety, and wandering in the evening, which can further add to the challenge of falling asleep. Researchers have known for some time that those with neurodegenerative conditions (such as AD) often have decreased melatonin levels and impaired circadian rhythms. Circadian rhythms refer to our 24-hour internal clock that helps to regulate certain physical, mental and behavioral actions (wake-sleep cycles, body temperature, blood pressure, metabolism, etc.). Researchers are now looking at whether circadian imbalances can actually be a contributing factor to some of these conditions. If so, can melatonin be used to help balance this circadian rhythm and improve outlooks for AD?
What is Melatonin?
Melatonin is one of dozens of naturally occurring hormones we create in our bodies. It is influenced by our circadian rhythm (and in turn, can impact our circadian rhythm), and is sometimes thought of as the ‘sleep switch’. It is produced in the pineal gland, close to the top of the brain stem. Our body’s melatonin production is triggered when it is dark (night time/dark rooms) and suppressed when it’s light (daytime/ sleeping with the lights on). We produce the most melatonin as toddlers and levels decrease as we age, resulting in about ¼ of the original levels by the time we reach our 60’s and 70’s.
There are several steps involved with our body’s ability to make melatonin and any deficiency in the sequencing steps may impact how much melatonin we produce.
How does Melatonin Help Us?
Having adequate levels of melatonin and healthy circadian rhythms have been shown to help with jet lag, thyroid health, certain cancers, obesity, PMS and decreasing inflammation but primarily people think of melatonin as the ‘sleep hormone’. Those with higher levels of melatonin fall asleep faster and sleep more soundly.
Melatonin and Alzheimer’s disease
Certainly the research is there that melatonin is often decreased and the circadian rhythm (the ‘master’ clock) is frequently off time in AD. However, newer research suggests these decreases are not necessarily simply a consequence of AD but could in fact be a contributor to the development of it. The outcome of these newer studies suggests that melatonin may provide a useful tool preventatively, in addition to its current use of treating some of the symptoms of AD.
Ways to Naturally Increase Melatonin
There are a number of ways to naturally increase melatonin production in our bodies.
- Increase certain fruit (tart cherries, pineapple, oranges, bananas), turkey, chicken and fish which helps to increase melatonin and its precursors
- Sleep in as dark a room as possible (be careful for AD patients if they are in a room by themselves as they may become more disoriented in the dark)
- Avoid sleeping late in the morning or having afternoon naps in a dark room
- Practice meditation, deep breathing exercises or yoga before bed
- Increase exposure to sunshine during the day
- Increase daytime exercise
The Bottom Line on Melatonin
Melatonin can be a very useful addition to treatment for Alzheimer’s patients to help improve both sleep quality and quantity and can also help patients experiencing ‘sundowning’ symptoms. It is not used at the same time as sedative medication (can result in an additive effect), but it can be a very beneficial tool for those needing help resetting their internal clock and can improve the ability to both fall asleep and stay asleep.
Side effects and Safety of Melatonin
Melatonin is available both orally and sublingually in various formats (chewable pills, capsules, gummies, sublingual strips and sprays). Amounts range from 0.1 mg up to 10 mg. depending on the age, health, weight, duration and medical condition it is being used to treat, but 1-3 mg per day is a common dosage. It is best taken shortly before bedtime and is usually well tolerated by most adults. Some people can have side effects, including increased sleepiness, vivid dreams, nausea or feeling a little groggy in the morning. Because of the sleepiness, driving should be avoided after using melatonin and those who are experiencing disorientation may need extra supervision. As always, check with your health care provider before starting melatonin as certain medications and health conditions may mean melatonin is contraindicated for your individual case.
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