Our sleep is regulated by homeostatic and circadian processes, causing feeling of sleepiness with activity, hours awake and darkness. Melatonin, the “sleep hormone”, acts in the circadian process but our natural levels decline from 35-years of age. This may lead to difficulty falling asleep or staying asleep, known as insomnia.
For management of long-term insomnia, lifestyle changes should be tried first. Practice good sleep hygiene by:
- Taking half an hour to wind down in the evening and only going to bed when you are ready for sleep.
- Establishing a routine where you are active through the day and going to sleep and waking at the same times each day.
- Making your bedroom dark, quiet, cool and comfortable.
- Removing stimulants and turning devices off an hour before bed.
- Avoiding caffeine, smoking and alcohol in the evening, instead trying chamomile tea or milky drinks.
- Getting up and doing something non-stimulating in another room if you don’t fall asleep within 30-minutes of going to bed. Reading, relaxation or yoga are good options.
If sleep still alludes you, your Pharmacist can offer you medicines to help. Melatonin slow-release tablets mimic the pattern of endogenous Melatonin if taken 1-2 hours before sleep. The tablets can be provided to adults over 55-years for short term treatment of insomnia (up to 13 weeks) that is not caused by other medical conditions. They should be swallowed whole and may take up to 3-weeks before the normal pattern of sleep-wake cycle is restored. It is best to avoid alcohol and other medicines for sleep while taking Melatonin. It is usually well tolerated and doesn’t seem to cause daytime drowsiness, dependence, withdrawal effects or rebound insomnia, however if drowsiness does occur, avoid driving or operating machinery. If you are affected by insomnia, speak to your Pharmacist or Doctor about what treatment will suit you best.