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A natural way to promote sleep?

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As more and more of us are troubled by sleep problems, ANNETTE CHRYSOSTOMOU questions whether you should follow the latest trend of taking melatonin

Sleep-deprivation was already a problem, then, Covid-19 happened. With the stress, grief, and anxiety of Covid-19 and its impact on daily life, people are reporting more sleep problems than ever before.

Around four in ten people reported trouble sleeping during the pandemic. Brought on by the stress of living in a global pandemic, sleep experts have labelled these sleep problems ‘coronasomnia’, the independent Sleep Foundation posted online.

Cyprus is no exception.

According to Nicosia-based pharmacist Evdokia Patsalidou sleep-related problems have escalated over the years. “There was the economic crisis in 2013, there is now an uncertainty in the job market which young people face, and to top it all, Covid,” she remarked.

“We have a ‘new’ illness – beyond the virus – to accompany our lives not yet fully coded, but with a big impact on public and personal health. Insomnia or other post/long covid symptoms affect a large proportion of the population,” associate professor and coordinator of the pharmacy programme at the University of Nicosia Christos Petrou added.

With more people opting for natural remedies, this means a growing number have turned to Melatonin, often dubbed a harmless food supplement.

It is available over the counter in pharmacies, in the form of 1mg pills.

When searching the internet, it quickly becomes clear that the pills may not be that harmless, as comments warn regular use may have side effects ranging from dizziness, stomach cramps, headaches and nausea to confusion and anxiety.

This may be true but is not supported by scientific evidence, Patsalidou said, since there is no clinical research done for food supplements, only for products which are registered as medicines.

“There is no description provided with the product, listing side effects, as for prescription medicines.”

Others are convinced the sleeping aid is better than other solutions.

“Especially for insomnia I am afraid that a lot of MDs will prescribe sedatives/sleeping pills instead of other interventions such as melatonin or valeriana,” Petrou commented.

George Ktenas, whose Nicosia-based pharmacy stocks plenty of natural remedies and supplements is sure it is a safe way of inducing sleep.

“Within the dosage, there are no side effects, people can take it for years without any problems,” he said. “With prescription medicines, many become addicted and may gain a lot of weight.”

He argues melatonin simply aids the natural process of hormones, which ensure that we feel tired at night, and when the sun rises again in the morning, the effect of melatonin wears off.

“To prevent many illness from developing, it is the most important thing to be relaxed and sleep regulation is a way to achieve this. Stress is the mother of all diseases.”

While he has decades of experience with the content of pharmaceutical products, Kyriakos Hadjilambris, MD and specialist in paediatrics and endocrinology, has also spent the same number of years treating patients, and he has a very different understanding.

“Melatonin helps for travelling, for example when it comes to Jet lag” he was quick to point out. “For a short time it is useful, but it definitely has side effects and can cause heart problems.”

He cites a paper published in the Journal of the American Medical Association in February which urges caution, warning adverse effects of melatonin use have been reported, and data on long-term use and high-dose use are still scarce.

The dose is definitely an issue.

While it is recommended on packages to take 1mg once a day, half an hour before sleeping, experts do not even agree on either the time before taking the sleeping aid and the dosage.

“It may take several hours,” said Dr Ilene M. Rosen, a sleep medicine doctor and associate professor of medicine at the Perelman School of Medicine at the University of Pennsylvania, “which is what I think is the misconception about how melatonin is used.”

“Most European countries accept you can use four doses,” Ktenas claims.

What comes up again and again in scientific articles: more research is needed regarding all sleeping aids, and this does not only concern melatonin and other so-called natural food supplements, but includes remedies such as chamomile tea, a beverage which has for centuries been used to treat health issues—including sleep problems.

The Sleep Foundation has this to say: “Many sleep problems are actually due to an undiagnosed sleep disorder or medical condition. Conducting a sleep study or other tests can shed light on these problems, which may need to be treated along with the insomnia itself.

“It is advisable to talk with a doctor before starting to use any natural sleep aid. Even though these products are available without a prescription, your doctor may be able to help in several ways.”

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