Posted by: Chris Maloney | September 27, 2012

Is Dr. Oz’s Dr. Breus Right About Melatonin Not Being Helpful For Sleep?

English: The core structure of primary melaton...

English: The core structure of primary melatonin receptor agonists (Photo credit: Wikipedia)

It’s not Dr. Oz, it’s his “sleep doctor” Dr. Michael Breus, PhD who trashes on melatonin.  As a man with many credentials, Dr. Breus honors the home shopping network with his expertise and salesmanship.  But is he right about melatonin?

Let’s start with his logic.  He states that melatonin is a hormone, and that:  “Hormones are naturally produced by your body as you need them. Which means it is very unlikely that someone has a melatonin deficiency.”

Gosh.  Maybe we should tell all the people with thyroid deficiency, or progesterone deficiency, etc.  that they don’t really need their medication.  What they need is going to be naturally produced.  I wish that were the case.

He goes on by stating:  “Melatonin is a sleep and body clock regulator – NOT a sleep initiator. Melatonin works with your biological clock by telling your brain when it is time to sleep. Melatonin does not increase your sleep drive or need for sleep.”

Ok, let’s look at some research.  Of the 589 research abstracts on melatonin and insomnia, let’s look at just the most recent.  “We conclude that a small dose of melatonin given daily, administered in the afternoon, could advance the sleep timing and make the students more alert during school days even if they continued their often irregular sleep habits during weekends.”  The study was randomized, double-blind, and placebo controlled.  It showed a beneficial effect in getting adolescents to fall asleep earlier.

But the good doctor Breus disagrees.  He says: “Melatonin is not considered an effective treatment for insomnia.”

Ok, “There is evidence that daytime administered melatonin is able to exhibit short-acting hypnagogic effect and phase-shifting of the circadian rhythms such that sleep timing and associated various physiological functions realign at a new desired phase. Under favor of these properties, melatonin and melatonin receptor agonists have been shown to be potent therapeutic agents for the treatment of circadian rhythm sleep disorders and some types of insomnia.”

In considering using melatonin before surgeries, researchers note: “Melatonin possesses sedative, hypnotic, analgesic, antiinflammatory, antioxidative, and chronobiotic properties that distinguish it as an attractive alternative premedicant.”

Melatonin is so effective for sleep that we have a new class of drugs, melatonin receptor agonists that use the same cell receptor sites as melatonin to induce sleep and calm.

But even if melatonin weren’t effective for insomnia, people should consider it for

Napoleon's Tail Fur Growth...after starting me...

Napoleon’s Tail Fur Growth…after starting melatonin (Photo credit: SewPixie)

other reasons.  The Cochrane review of melatonin showed it “may benefit cancer patients who are also receiving chemotherapy, radiotherapy, supportive therapy, or palliative therapy by improving survival and ameliorating the side effects of chemotherapy.”

Dr. Breus also recommends an incredibly low dose of melatonin (less than 1 mg).  Even in the studies of the elderly, the researchers put study patients on twice what he recommends.  In animal studies, larger doses of melatonin had similar anxiety reducing effects as diazepam (valium).  And even at those enormous doses, the animals suffered no ill effects.

In human studies, doses of 3 mg were not high enough to affect hormones in breast cancer survivors, but a much higher dose may be helpful.

In terms of buildup, a study of the elderly showed no significant difference between an intake of 0.4 mg and 4 mg in terms of the body’s ability to process it.

Now, Dr. Breus says not to give melatonin to children.  He says it may cause a number of things, including nightmares.  I think I will quote this abstract in full, because I really can’t say it better myself.

“Melatonin is beneficial not only in the treatment of dyssomnias, especially delayed sleep phase syndrome, but also on sleep disorders present in children with attention-deficit hyperactivity, autism spectrum disorders, and, in general, in all sleep disturbances associated with mental, neurologic, or other medical disorders. Sedative properties of melatonin have been used in diagnostic situations requiring sedation or as a premedicant in children undergoing anesthetic procedures. Epilepsy and febrile seizures are also susceptible to treatment with melatonin, alone or associated with conventional antiepileptic drugs. Melatonin has been also used to prevent the progression in some cases of adolescent idiopathic scoliosis. In newborns, and particularly those delivered preterm, melatonin has been used to reduce oxidative stress associated with sepsis, asphyxia, respiratory distress, or surgical stress. Finally, the administration of melatonin, melatonin analogues, or melatonin precursors to the infants through the breast-feeding, or by milk formula adapted for day and night, improves their nocturnal sleep. Side effects of melatonin treatments in children have not been reported (bold mine)”  Here’s the abstract, which leads to a free article from the International Journal of Pediatrics published last year.

Dr. Beus apprears to be wrong about melatonin’s effect, dosage, and its use in children.  I can only hope that the wide dissemination of his information does not completely derail the use of melatonin, making patients far more likely to take the new drug versions of melatonin.  Hopefully people read the whole of his article, which adds:  ” Tart cherries contain a natural melatonin, and there is research to show that drinking tart cherry juice can help with insomnia.”  So melatonin does help with insomnia, at least when it’s part of cherry juice.



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