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Melatonin Side Effects In Elderly With Dementia

Side Effects Of Melatonin Interactions

Melatonin over-use could could cause dementia
  • Sleepiness and drowsiness with sedative medication the interaction between sedative medications or depressants and melatonin can lead to excessive daytime sleepiness and drowsiness. It is essential you avoid taking melatonin with medications like lorazepam, clonazepam, zolpidem, etc.
  • Wakefulness with caffeine combining melatonin with caffeine may result in decreased melatonin effects. Caffeine will overpower melatonin, so instead of sleepy, one might feel more wakeful and alert.
  • Increased blood sugar with diabetes medication because melatonin increases blood sugar levels, and the diabetic medication lowers it, it can completely overpower the effectiveness of diabetes medication. This can lead to some serious issues in diabetic patients, who should avoid taking melatonin with insulin, glimepiride, glipizide, rosiglitazone, etc.
  • Bleeding risk with anticoagulants because melatonin slows down blood coagulation, it should be smart to avoid taking it together with medication that has the same effects. The combination of anticoagulants with melatonin may cause bleeding and bruising. Such medications include aspirin, ibuprofen, naproxen, enoxaparin, heparin, diclofenac, etc.

When To Steer Clear

Certain people should be more cautious about melatonin use, particularly if it triggers a negative reaction, including those with:

  • Chronic insomnia. Having trouble falling asleep or staying asleep that lasts a month or more shouldn’t be managed with melatonin, according to the American Academy of Sleep Medicine and the American College of Physicians. These groups recommend other more proven remedies , noting that there is not enough evidence that melatonin is safe and effective for long-term use.
  • Restless Legs Syndrome . The tingling or “creepy-crawly” feeling in the legs that often keeps people awake could be worsened by melatonin. The supplement can intensify RLS symptoms because it lowers the amount of dopamine in the brain, according to the Restless Legs Syndrome Foundation. If you’ve been diagnosed with RLS or suspect that you have the condition, talk to your HCP about lifestyle changes or medications that could help.
  • Dementia. This progressive cognitive deterioration is often associated with insomnia, which can tax both patients and their caregivers. But melatonin may do more harm than good among those with dementia since the condition causes people to metabolize the supplement more slowly, resulting in daytime drowsiness. In people with moderate or severe dementia, melatonin supplementation may increase the risk of falls, according to 2015 guidelines from the American Academy of Sleep Medicine.

If you’ve been drinking alcohol, it’s also not safe to take melatonin.

Dementia And Sleep Problems: Causes

Dementia permanently and progressively changes how the brain works. With most types of dementia, tangles of protein accumulate in the brain, damaging brain function. Over time, these proteins accumulate throughout the brain, damaging many aspects of functioning. As a result, the symptoms of various dementias tend to look more similar over time.

As plaques accumulate in the brain, they can damage various brain functions, as well as the bodys ability to regulate the sleep-wake cycle. This causes symptoms such as insomnia, nighttime restlessness, and changes in mood and behavior when the sun sets.

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Common Sleep Problems In People With Dementia

Sleep changes are common in older adults with and without dementia. Many seniors experience changes in the quality of their sleep, the number of hours they sleep, and how much time they spend awake at night. In fact, older adults total sleep time decreases by about 30 minutes per decade starting in middle age.

Sleep problems are even more common in people with dementia. The type and severity of sleep disturbances may vary depending on the cause of your loved ones dementia and the stage of their disease. Sleep problems associated with dementia tend to get worse as the disease progresses.

Your loved one with dementia may experience the following sleep problems:

  • Difficulty maintaining or falling asleep, which can be caused by insomnia, problems with the sleep cycle, side effects of medication, or other factors.
  • Sundown syndrome, which is common in people with Alzheimers and other forms of dementia, can contribute to problems with sleep. Sundown syndrome refers to increased confusion, agitation, anxiety, and aggression in the evening or during the night.
  • Problems with movement during sleep, such as restless legs syndrome which is characterized by an uncomfortable urge to move the legs during periods of rest or rapid eye movement sleep behavior disorder, which makes people act out their dreams.
  • Breathing disorders during sleep, such as sleep apnea, which affects about 50% of people with Alzheimers.

How Can Alzheimers Patients Get Better Sleep

Is Melatonin Safe for Elderly with Dementia

Helping an individual with Alzheimers to sustain longer, deeper sleep can result in physical health gains and improvement of daytime symptoms that sleep loss causes, such as agitation and disorientation. In addition to treating any underlying sleep disorders that are contributing to disturbed sleep, practicing good sleep hygiene can help people with Alzheimers to sleep better. Sleep hygiene means cultivating healthy sleep habits and maintaining an environment that promotes quality sleep. Experiment with the following steps to improve sleep hygiene:

These approaches to sleep hygiene may be challenging to implement for some patients, but evidence suggests that such efforts can pay off. A study found that, compared to a control group, implementation of sleep hygiene practices, daily walks, and exposure to a lighting device resulted in a reduction in time awake at night and depression in Alzheimers patients and that these gains were sustained after six months.

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Assisting Seniors With Insomnia: A Comprehensive Approach

Darrell Hulisz, RPh, PharmDAssociate Professor of Family MedicineCase Western Reserve University School of MedicineAssociate Clinical Professor of Pharmacy PracticeOhio Northern University College of PharmacyCleveland, OhioOhio Northern University College of PharmacyCleveland, Ohio US Pharm

Insomnia is a common but often underdiagnosed complaint in the elderly population.1 It is defined as the inability to obtain sleep of sufficient quality or quantity to feel refreshed the following morning.2,3 Insomnia is characterized by difficulty initiating and/or maintaining sleep. More than 50% of geriatric patients have reported repeated difficulty falling and staying asleep, trouble waking, waking up too early, or needing to nap without feeling rested.1 Changes in the amount and quality of sleep are associated with advancing age.4

The Possible Dangers Of Using Melatonin Long

Melatonin is naturally produced in your body and helps determine the timing of your circadian rhythm. Its released to signal to the body that its time to go to sleep. But this isnt all the hormone does it also impacts the bodys temperature, blood sugar, and blood vessel tone which is the degree of constriction experienced by a blood vessel compared to the maximum dilated state.

As with many hormones in our bodies, having too much or too little melatonin in your system long term can cause health concerns. The problem when taking a melatonin supplement is that since its not a drug, theres no oversight or regulation by the FDA.

Studies have shown that melatonin products often contain inconsistent dose labeling. This makes it hard to know exactly how much melatonin youre taking. In addition to inconsistent dosing, researchers have also found serotonin present in these products. Taking an unknown dose of serotonin for a long time can affect your heart, blood vessels, and brain. People taking medication for a mood disorder should be especially careful, as these medications already boost serotonin so an extra dose of serotonin can particularly impact them.

This increased consumption of melatonin or serotonin is mostly a risk due to the rate at which people are relying on melatonin as a nightly sleep aid. People think of melatonin as an all-natural supplement and therefore dont think anything of taking it every day instead of taking it for occasional sleep disruptions.

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Is Melatonin For Alzheimers Safe Learn How It Can Help

Alzheimers Disease is a neurodegenerative condition that causes ongoing damage to the cells in the brain,

affecting memory, speech, and mobility, and making it difficult to carry out some normal, everyday tasks.

Its a very common condition, and its estimated that around 25 million people have Alzheimers Disease around the world.

There is no cure for Alzheimers, but there are some treatment options.

New Alzheimers research has focused upon more natural ways to manage the symptoms of Alzheimers Disease.

Vitamins such as vitamin B6 and vitamin B9 have been shown to be beneficial in reducing the risk of Alzheimers Disease,

but perhaps of even more interest is the recent research into ways to minimize some of the symptoms in existing patients,

helping them to enjoy a higher quality of life. One of the most promising natural treatments for Alzheimers is melatonin.

What is Melatonin?

Melatonin is a chronobiotic hormone, which means that its produced rhythmically by the pineal gland,

giving it a certain power and control over internal processes.

Thanks to the synchronized production, melatonin has the ability to influence the bodys cycle throughout the day

essentially, the body knows when melatonin is secreted and operates accordingly.

There are many aspects that are believed to be somewhat regulated by the production and release of melatonin,

including the sleep/wake cycle, core temperature, and brain-body communications through neurological pathways.

Vital Regulatory Functions And Rhythms

Health experts warn of risks with taking melatonin

The bodys biological clock regulates hormonal fluctuations, which evolve over a persons lifespan. As a result, aging often affects activities such as sleep and wake patterns, which, in some cases, become increasingly disrupted and fragmented.

Melatonin is a key hormone that governs the bodys circadian rhythms. Circadian rhythms play an influential role in certain aspects of our bodily functions and behaviors. They also play a significant part in sleep regulation and overall good health in humans, and their disruption can have numerous consequences.

The negative consequences of sleep deprivation can include lower vigor, a less positive mood, and feeling stressed, cold, or sleepy. These effects can occur in people of any age.

MNT spoke with Dr. Richard Castriotta, a sleep medicine specialist at Keck Medicine of USC in Los Angeles who was not involved in the study. When we asked what the real-world implications of this study are, he stated:

Not much, except that the increasing use of melatonin, like any non-FDA-approved medication sold as a nutritional supplement, increases the risk of untoward side effects from a bad batch of unsupervised manufacture or extraction .

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How Do Our Sleep Patterns Change As We Age

There is a common misconception that people need less sleep with age. The truth is, though, people aged 50 years and older need the same 7-8 hours of sleep.

So, is the sleep of an elderly person different from that of an adult? Due to a decrease in melatonin production, older people need an average of 30 minutes longer to fall asleep. Besides, they often have a more sensitive sleep, which means a shifted balance between REM and non-REM stages as well as an increased likelihood of sleep fragmentation .

Circadian rhythms also shift with age, so the elderly often go to bed earlier than usual and get up earlier too. Sleep patterns changing with age is a normal physiological process, but sleep quality of older people is often significantly disrupted by sleep-related problems or chronic illnesses such as:

  • snoring or sleep apnea
  • neurodegenerative diseases such as dementia or Alzheimer’s disease

All these conditions can over time result in a chronic lack of sleep.

Melatonin Safety In People With Dementia

People with dementia may react more strongly to certain drugs than people without dementia. They may also be anxious about taking medication. So start with a low dosage of melatonin1 to 2 mg, and gradually increase to 2.5 to 5 mg based on the persons response to the drug.

If the person with dementia takes other drugs, be sure to clear melatonin with their provider first. The more medications a person takes, the more likely they are to experience negative drug interactions and side effects.

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What Are The Health Benefits Of Taking Melatonin

Melatonin supplements may help with certain conditions, such as jet lag, delayed sleep-wake phase disorder, some sleep disorders in children, and anxiety before and after surgery.

Jet lag

Jet lag affects people when they travel by air across multiple time zones. With jet lag, you may not feel well overall and you may have disturbed sleep, daytime tiredness, impaired functioning, and digestive problems.

Research suggests that melatonin supplements may help with jet lag. This is based on medium-sized reviews from 2010 and 2014.

  • Four studies that included a total of 142 travelers showed that melatonin may be better than a placebo in reducing overall symptoms of jet lag after eastward flights. Another study of 234 travelers on eastward flights looked at only sleep quality and found low-quality evidence that melatonin may be better than placebo for improving sleep quality.
  • Two studies that included a total of 90 travelers showed that melatonin may be better than a placebo in reducing symptoms of jet lag after westward flights.

Delayed sleep-wake phase disorder

People with DSWPD have trouble falling asleep at the usual times and waking up in the morning. They typically have difficulty getting to sleep before 2 to 6 a.m. and would prefer to wake up between 10 a.m. and 1 p.m.

Some sleep disorders in children

Because of these uncertainties, itâs best to work with a health care provider if youâre considering giving a child melatonin for sleep problems.

The Relationship Between Dementia And Sleep

Is Melatonin Safe? All About the Popular Sleep Supplement

Sleep and dementia is a complicated topic. Different types of dementia are associated with different sleep problems. Researchers are also not yet sure which way the interaction goes – whether poor sleep causes or exacerbates dementia or if dementia leads to poor sleep. Some researchers believe that both of these theories could be true, and the relationship could be circular.

On top of this, it is unclear what the mechanisms are that underlie these interactions.

It is clear that more research is needed to understand this relationship in particular research that observes large groups of affected people for very long periods of time.

Dementia research volunteering

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Reasons To Be Cautious About Melatonin

Your sleep-deprived friends may swear by it and you’ve probably read about it online or seen it on drugstore shelves. But is melatonin all it’s cracked up to be, or are you better off just counting sheep to get some ZZZs?

First, the basics: Melatonin is a naturally occurring hormone in the brain that your body uses to help regulate your circadian rhythm. That’s the 24-hour body clock that, among other vital functions, tells you when to sleep and when to wake up each day.

Your body gradually starts making melatonin about two hours before bedtime, bringing on that familiar drowsy feeling, and production continues throughout the night. In fact, melatonin is often called the “Dracula of hormones” because levels rise when it gets dark outside. As sunrise approaches, levels begin to drop, letting you know it’s time to rise for the day.

Given melatonin’s essential role in the body’s internal clockworks, many people assume the supplement is safe. This may be one reason why it has become the fourth most popular supplement among U.S. adults, according to a National Health Interview Survey. Its use doubled between 2007 and 2012, as more than three million adults reported taking the sleep aid.

And it is true: Melatonin is generally harmless – at least if you take it for a short period of time.

Sleep Medications Affect Certain Races Differently

Researchers at the University of California, San Francisco studied white and African American adults between ages 7079 who were not living with dementia at the start of the study. The researchers followed participants for 15 years and found that participants who said they took sleep medications often or almost always were more likely to develop dementia than those who said they never or rarely took sleep medications. However, the team only found an increased dementia risk among white males who commonly took sleep medications.

Based on our findings, we recommend that clinicians make more effort to be aware of their patients sleep problems including use of sleep aids, said lead study author Yue Leng, PhD, University of California, San Francisco. In particular, clinicians may need to be more cautious about prescribing sleep medications to older adults who are at high risk for dementia. There are non-pharmacological sleep treatment options that should be considered.

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Cognitive Behavioral Therapy For Insomnia

CBT-i has been shown to be an effective treatment modality to improve sleep quality and is typically considered part of first-line therapy for insomnia in the general population . A Cochrane review concluded that, in adults aged > 60 years with sleep problems, CBT-i is effective, particularly for sleep maintenance . In the elderly, CBT-i has been shown to be superior to pharmacotherapy in terms of efficacy and sustained benefit in multiple randomized, placebo-controlled studies . A twoarm randomized controlled trial on CBT-i in people with mild cognitive impairment and insomnia demonstrated significant improvement in sleep onset latency , SE, wake after sleep onset , and insomnia severity, along with notable effect sizes in subjects receiving CBT-i compared with controls . CBT-i has been shown to improve cognitive function in older adults with MCI and is currently being evaluated to see whether it has the ability to reduce A deposition .

Is Melatonin Safe For Patients With Dementia

Melatonin wont help everyones sleep issues, experts say

The supplements are generally safe and can be used to treat insomnia in people who have trouble getting quality sleep.

The drugs can improve sleep moderately.

Even though the drugs may be safe for most healthy people, some experts do not recommend melatonin for seniors with dementia.

This view has been backed by the American Academy of Sleep Medicine.

The institution does not advise elderly people with dementia to use melatonin or other sleep-promoting drugs.

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