Insomnia is a common problem among elderly individuals, affecting over one-third of persons over age 65, according to the National Institute on Aging. Insomnia is particularly prevalent among menopausal women. A July 2005 review in "Journal of Clinical Sleep Medicine" reports that insomnia is one of the hallmarks of menopause, and it is often due to hot flashes, which are part of the transition to menopause. Women often seek relief from menopausal symptoms in non-prescription remedies. Melatonin has been advocated as useful for both hot flashes and insomnia.
Melatonin Regulates Sleep Cycles
Melatonin is a hormone produced by the pineal gland at the base of your brain. It is instrumental in regulating your response to light exposure and in establishing your sleep-wake cycles. According to a review in the October 1995 "Aging," your ability to produce melatonin drops dramatically as you grow older. This age-related decline in melatonin may lead to a variety of physiologic changes, but a disruption of your sleep could be one of the most troublesome.
Melatonin and Hot Flashes
Hot flashes are a common part of early menopause, and they frequently interfere with a woman's sleep. Due to concerns that hormone replacement therapy increases the risks for breast cancer, strokes, heart disease and clotting disorders, women are turning to alternative remedies for hot flashes, including melatonin. Clinical trials evaluating the effectiveness of melatonin for controlling hot flashes have produced conflicting results. A review in the September-October 2010 "Journal of the American Pharmacists' Association" reported that there was insufficient evidence to support the use of melatonin for hot flashes.
Melatonin for Menopausal Insomnia
Despite the lack of clear benefit from melatonin for hot flashes, studies show that melatonin therapy, particularly with prolonged-release formulations, can be useful for insomnia in middle-aged and older adults. A study in the January 2011 "Current Medical Research and Opinion" showed that melatonin not only improves sleep patterns in individuals over 55 years of age, but it does so without signs of intolerance, withdrawal or rebound.
Considerations and Recommendations
Melatonin may be beneficial for some menopausal women who suffer from insomnia. However, menopause is not the only cause of insomnia in middle-aged and older women. Depression, medications, sleep apnea and other potential causes should be ruled out before melatonin is used for menopausal insomnia. Studies using 2 mg of prolonged-release melatonin one to two hours before bedtime have shown benefit. If you suffer from menopausal insomnia and think melatonin would be of benefit to you, talk to your doctor.
References
- "Sleep"; Sleep Complaints among Elderly Persons: An Epidemiologic Study of Three Communities; D.J. Foley, et al.; July 1995
- "Journal of Clinical Sleep Medicine"; Menopause Related Sleep Disorders; P.S. Eichling, J. Sahni; July 2005
- "Aging"; Oxygen Radical Detoxification Processes during Aging: The Functional Importance of Melatonin; R.J. Reiter; October 1995
- "Journal of the American Pharmacists' Association"; Evaluating the Evidence for Over-the-Counter Alternatives for Relief of Hot Flashes in Menopausal Women; K.W. Kelley, D.G. Carroll; September-October 2010
- "Current Medical Research and Opinion"; Prolonged Release Melatonin in the Treatment of Primary Insomnia: Evaluation of the Age Cut-off for Short- and Long-term Response; A.G. Wade, et al.; January 2011
