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L-C

Advice requested: melatonin

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Has anyone used melatonin to treat problems with sleep? Every night I wake up at least once before I'm supposed to, and I can never reach 8 hours of sleep. Usually 5-6.5 and I need more.

Unfortunately melatonin is prescription-only in Sweden and in practice it's never prescribed (other than in rare cases at a rate of $1.5 per pill), but it's not classified as a narcotic so I'd guess the worst that could happen when trying to import it would be having it seized by customs. What are the factors to look for with regard to dosage, brands, type (regular vs time release etc.) and so on?

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I use it. It's over the counter in the US. There are 1 mg and 5 mg dosages. My doctor recommended I take the 1 mg. dosage. There's information on the internet but it's best not to take too much. It's just supposed to replace what your body would normally replace. Too much suppresses normal production, which has already decreased due to age. Still don't get 8 hours sleep. But it helps.

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Melatonin is OK for short term use but can lead to a disruption of your own melatonin production if used for long. It can be effective, however, melatonin is important to fall asleep - not to stay asleep.

For your problem, you can try to to manipulate other variables; I would start with food and stress reduction. Make sure your room is completely blacked out (no LEDs), quiet (no pets), and on the cool side.

A less disruptive solution (than melatonin) is a bright lamp which you use for 15-30mn every morning to reset your cycle (it's also important to stay away from screens at night - no TV, no computers). I use the one below - I love it, it's very effective:

http://www.amazon.com/Sphere-Gadget-Technologies-SP9882-Lightphoria/dp/B004JF3G08/

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I am not a medical person. I am not qualified to offer medical advice. What follows are suggestions that you might want to discuss with your doctor.

A common reason for sleep disruption is breathing disorders. The most common of these is sleep apnea. If you have reason to think that this might be your issue, then spending a night in a sleep lab would give you a definitive diagnosis.

Sleep apnea is caused by the airways shutting down during sleep. Breathing can stop for minutes at a time. This causes the sufferer to be jerked awake to resume breathing, disrupting REM sleep. Another serious effect of sleep apnea is that the oxygen level in the blood drops and this can have lasting effects on the brain.

The treatment for sleep apnea involves wearing a mask hooked up to a continuous or bi-level positive air pressure machine. These are commonly referred to as CPAP or BiPAP machines.

The conventional wisdom is that sleep apnea afflicts only overweight and obese people. This is not true. Normal weight people can have sleep apnea. However, it is true that incidence of sleep apnea is strongly correlated with obesity.

Another possible reason that you wake up at night is your prostate size. If you are past middle age you almost certainly have an enlarged prostate. This can cause pressure in your bladder that can wake you. There are no satisfactory ways to reduce prostate size. There are some strategies you can adopt to minimize the problem. E.g., don't drink anything within three hours of bedtime. E.g., learn relaxation techniques to help you go back to sleep after you have awakened. Especially, don't think of topics that cause you anxiety. E.g., schedule a time to take a nap in the daytime.

As a final suggestion, if you are sedentary you could start doing aerobic exercise (after getting your doctor's opinion that this is safe). Here are two studies on this:

http://www.ncbi.nlm....pubmed/22019457

http://www.ncbi.nlm....pubmed/20572421

A lot of research has been done on melatonin. You can access it by going to Google advanced search and inputting the search terms "melatonin" and "insomnia" and restricting the domain to .gov

I hope this helps.

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I did a lot of research on the subject because I had the same problem. Other things that can cause this waking up in the middle of the night include:

- too much alcohol too late in the evening,

- too much carbs in the evening,

- too few calories in the evening (eat a piece of cheese before going to bed),

- mineral defficiencies in particular in zinc and magnesium (there's a combined supplement called ZMA which is considered very effective).

As a side note, one of the most endorsed remedy to go back to sleep if you were to wake up in the middle of the night is ... any form of sexual release.

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I'm 26, 6'1" and 185 lbs, I take zinc and magnesium supplements, don't drink, do eat a piece of cheesde before going to bed, and go to the gym several times a week. I suspect I have obstructive sleep apnea to some extent, however, and will get a nose/throat exam next month. Possibly I'll start to use a splint to keep my jaw pushed forward during sleep.

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Do you work out intensely? Are you on a calorie deficit? Lots of stress in your everyday life? If you answer yes you could try taking 2-3 weeks off from exercise, eat more food and try to reduce other stressors.

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I've had this problem since February and have tried altering those things. I'd say stress is lower than it was before that time. Very consistently I wake up after 6 hours even though I need more.

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I'm 26, 6'1" and 185 lbs, I take zinc and magnesium supplements, don't drink, do eat a piece of cheesde before going to bed, and go to the gym several times a week. I suspect I have obstructive sleep apnea to some extent, however, and will get a nose/throat exam next month. Possibly I'll start to use a splint to keep my jaw pushed forward during sleep.

Get a CPAP. The will completely control the sleep apnea.

ruveyn

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This is Sweden, I can't just get one. Maybe if I travel abroad and manage to convince someone to sell me one.

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This is Sweden, I can't just get one. Maybe if I travel abroad and manage to convince someone to sell me one.

you can order one from India. They do not require prescriptions on their medical websites.

CPAP devices are standard medical items for dealing with obstructive pulminary conditions. I recommend you check that out more carefully.

ruveyn

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This is Sweden, I can't just get one. Maybe if I travel abroad and manage to convince someone to sell me one.

I would not recommend using a medical device without a doctor's recommendation.

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That doesn't work in a system of socialized medicine. Priorities, incentives, attitude etc. are all screwed up. There's a saying that goes "You have to be healthy to survive Sweden's healthcare".

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I'll give you a bit of background to explain the situation better. Who knows, the US might be facing a similar situation soon enough...

Patients in Sweden only pay a small proportion of their total healthcare expenses out of pocket. The rest is tax funded. This means that patients are not proper customers from which the service provider stands to lose a great deal should they fail to deliver. There's also a lack of competition since most people are taxed out of the ability to afford private healthcare.

These and other factors have a variety of consequences for the way a person deals with the healthcare system. One is that the government sets the terms (as anyone who pays, whether or not their money is stolen, is wont to do) for how the patient-doctor interaction is to be done; for example, you can't "shop around" for doctors: one is appointed to you. You can't call them, instead you have to call your health center which then sets you up for a "phone appointment" at a time of their choosing, for a fee.

Another is the arrogant and dismissive attitude of Swedish doctors. This has led to a lot of people preferring to be assigned any doctor with a foreign-sounding name - in a country where a foreign-sounding name will often get your resume thrown in the bin by employers! These doctors can't be fired and aren't subject to market forces. They will spend as little time talking to you as they can get away with, will routinely dismiss your health problems as psychosomatic, and have no qualms about refusing to prescribe the best treatments (various drugs or apparatus) if it means less pressure on the public budget.

It's a top-down arrangement, and you're the bottom. Pun intended.

The way this pertains to my situation, Paul, is that such a doctor's recommendation, or lack of one, would not be based on the medical facts and my status as a customer. Hence I can't rely on it.

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L-C, I can send you a box of Melatonin if you want. I'd get Now Foods brand from Amazon, that's what I buy for myself. It would probably be less than $20-$30 to get them here and send them back to you. It's not a long term solution for you, but if you're dead set on trying it I'm happy to help.

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