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Considering Melatonin for Sleep? Here’s a Guide to Help Considering Melatonin for Sleep? Here’s a Guide to Help
(about 13 hours later)
It’s understandable that you may be struggling to fall asleep these days. Our world has been turned upside down, so it is especially hard to unplug from the day and get the high-quality sleep your body needs.It’s understandable that you may be struggling to fall asleep these days. Our world has been turned upside down, so it is especially hard to unplug from the day and get the high-quality sleep your body needs.
“Almost every single patient I’m speaking with has insomnia,“ said Dr. Alon Y. Avidan, a professor and vice chair in the department of neurology at the David Geffen School of Medicine at the University of California, Los Angeles, and director of the U.C.L.A. Sleep Disorders Center. “Especially now with Covid-19, we have an epidemic of insomnia. We call it Covid-somnia.”“Almost every single patient I’m speaking with has insomnia,“ said Dr. Alon Y. Avidan, a professor and vice chair in the department of neurology at the David Geffen School of Medicine at the University of California, Los Angeles, and director of the U.C.L.A. Sleep Disorders Center. “Especially now with Covid-19, we have an epidemic of insomnia. We call it Covid-somnia.”
An increase in anxiety in both children and adults is affecting our ability to fall asleep. Additionally, our lifestyles have changed drastically as people observe sheltering in place guidelines. With more people staying indoors, it can mean they are not getting enough light exposure.An increase in anxiety in both children and adults is affecting our ability to fall asleep. Additionally, our lifestyles have changed drastically as people observe sheltering in place guidelines. With more people staying indoors, it can mean they are not getting enough light exposure.
“Without light exposure in the morning,” Dr. Avidan said, people “lose the circadian cues that are so fundamentally important in setting up appropriate and normal sleep-wake time.”“Without light exposure in the morning,” Dr. Avidan said, people “lose the circadian cues that are so fundamentally important in setting up appropriate and normal sleep-wake time.”
There are nonmedical ways to help you sleep better: Meditation, turning off screens early in the night, warm showers and cool bedrooms can help your body rest better. But if these options don’t work, or if you are ready for the next step, you may have considered trying melatonin supplements. These pills are commonplace enough that you have most likely heard of them and seen them in your local pharmacy.There are nonmedical ways to help you sleep better: Meditation, turning off screens early in the night, warm showers and cool bedrooms can help your body rest better. But if these options don’t work, or if you are ready for the next step, you may have considered trying melatonin supplements. These pills are commonplace enough that you have most likely heard of them and seen them in your local pharmacy.
Here’s what you need to know about the pros and cons of using melatonin supplements for sleeping difficulties.Here’s what you need to know about the pros and cons of using melatonin supplements for sleeping difficulties.
Melatonin is a hormone that helps regulate sleep timing. It is produced in the pea-size pineal gland, which is nestled in the middle of your brain and syncs melatonin production with the rising and setting of the sun. According to the National Sleep Foundation, the gland remains inactive during the day but switches on around 9 p.m. (when it’s generally dark) to flood the brain with melatonin for the next 12 hours.Melatonin is a hormone that helps regulate sleep timing. It is produced in the pea-size pineal gland, which is nestled in the middle of your brain and syncs melatonin production with the rising and setting of the sun. According to the National Sleep Foundation, the gland remains inactive during the day but switches on around 9 p.m. (when it’s generally dark) to flood the brain with melatonin for the next 12 hours.
Melatonin itself doesn’t make you fall asleep; it just tells your body that it’s time to fall asleep by lowering alertness and reducing your core body temperature. It works in tandem with the body’s circadian rhythms to let you know when you should rest and when you should be awake.Melatonin itself doesn’t make you fall asleep; it just tells your body that it’s time to fall asleep by lowering alertness and reducing your core body temperature. It works in tandem with the body’s circadian rhythms to let you know when you should rest and when you should be awake.
“Melatonin is the hormone of darkness and you need it to start falling asleep,” Dr. Avidan said. “The reverse also happens. If you expose yourself to too much light at night, you actually delay the production and release of melatonin.” This is why experts suggest you avoid computers and smartphones before bedtime.“Melatonin is the hormone of darkness and you need it to start falling asleep,” Dr. Avidan said. “The reverse also happens. If you expose yourself to too much light at night, you actually delay the production and release of melatonin.” This is why experts suggest you avoid computers and smartphones before bedtime.
You can buy synthetic melatonin supplements over the counter. They are generally considered safe and nonhabit-forming. Dr. Avidan says melatonin supplements can be effective for most people: “For all practical purposes, it probably helps.”You can buy synthetic melatonin supplements over the counter. They are generally considered safe and nonhabit-forming. Dr. Avidan says melatonin supplements can be effective for most people: “For all practical purposes, it probably helps.”
However, he cautions, melatonin’s success depends on three things:However, he cautions, melatonin’s success depends on three things:
When you take it.When you take it.
How much you take.How much you take.
If the amount you take is the actual dose written on the box.If the amount you take is the actual dose written on the box.
These products work best for two kinds of short-term sleep problems.These products work best for two kinds of short-term sleep problems.
First, melatonin supplements are useful when you have a circadian rhythm disorder such as jet lag or sleep pattern disruptions resulting from shift work. When used to treat these conditions, melatonin supplements signal to the brain that it is nighttime and the body should start winding down.First, melatonin supplements are useful when you have a circadian rhythm disorder such as jet lag or sleep pattern disruptions resulting from shift work. When used to treat these conditions, melatonin supplements signal to the brain that it is nighttime and the body should start winding down.
In these instances, said Dr. Bhanu Kolla, an associate professor in psychiatry and psychology and a consultant in sleep medicine at the Center for Sleep Medicine at the Mayo Clinic, it is best to use low doses of melatonin supplements. Consult with a doctor if you have any questions or concerns.In these instances, said Dr. Bhanu Kolla, an associate professor in psychiatry and psychology and a consultant in sleep medicine at the Center for Sleep Medicine at the Mayo Clinic, it is best to use low doses of melatonin supplements. Consult with a doctor if you have any questions or concerns.
The second use for melatonin supplements is when you have difficulty falling asleep and staying asleep. Over all, Dr. Kolla said, melatonin supplements, if taken before bedtime, reduce the time to fall asleep. In one study published in PLOS One, people who took melatonin supplements fell asleep seven minutes faster and increased overall sleep time by eight minutes. Researchers found that overall sleep quality was improved too.The second use for melatonin supplements is when you have difficulty falling asleep and staying asleep. Over all, Dr. Kolla said, melatonin supplements, if taken before bedtime, reduce the time to fall asleep. In one study published in PLOS One, people who took melatonin supplements fell asleep seven minutes faster and increased overall sleep time by eight minutes. Researchers found that overall sleep quality was improved too.
For those addressing sleep regulation issues, experts suggest taking 0.5 milligrams two to three hours before bed. For people with insomnia who need help falling asleep, you can take 5 milligrams 30 minutes before bedtime.For those addressing sleep regulation issues, experts suggest taking 0.5 milligrams two to three hours before bed. For people with insomnia who need help falling asleep, you can take 5 milligrams 30 minutes before bedtime.
“We try to recommend low doses,” said Dr. Rachel Marie E. Salas, an associate professor of neurology and nursing at Johns Hopkins Medicine. “Again, this is not a prescribed medication, so there is a great deal of variability.”“We try to recommend low doses,” said Dr. Rachel Marie E. Salas, an associate professor of neurology and nursing at Johns Hopkins Medicine. “Again, this is not a prescribed medication, so there is a great deal of variability.”
Most people end up taking melatonin supplements without consulting a physician, Dr. Kolla said. “If you have any major health conditions such as liver failure, renal failure or are pregnant,” he said, it is always best to consult your physician before taking melatonin supplements.Most people end up taking melatonin supplements without consulting a physician, Dr. Kolla said. “If you have any major health conditions such as liver failure, renal failure or are pregnant,” he said, it is always best to consult your physician before taking melatonin supplements.
Melatonin supplements can cause dizziness and headaches. Occasionally, people might feel a little groggy during the day, but over all, Dr. Kolla said, melatonin is safe to take. Because melatonin can cause daytime drowsiness, the Mayo Clinic warns that you shouldn’t drive or operate machinery within five hours of taking it.Melatonin supplements can cause dizziness and headaches. Occasionally, people might feel a little groggy during the day, but over all, Dr. Kolla said, melatonin is safe to take. Because melatonin can cause daytime drowsiness, the Mayo Clinic warns that you shouldn’t drive or operate machinery within five hours of taking it.
Updated June 16, 2020Updated June 16, 2020
The steroid, dexamethasone, is the first treatment shown to reduce mortality in severely ill patients, according to scientists in Britain. The drug appears to reduce inflammation caused by the immune system, protecting the tissues. In the study, dexamethasone reduced deaths of patients on ventilators by one-third, and deaths of patients on oxygen by one-fifth.
The coronavirus emergency relief package gives many American workers paid leave if they need to take time off because of the virus. It gives qualified workers two weeks of paid sick leave if they are ill, quarantined or seeking diagnosis or preventive care for coronavirus, or if they are caring for sick family members. It gives 12 weeks of paid leave to people caring for children whose schools are closed or whose child care provider is unavailable because of the coronavirus. It is the first time the United States has had widespread federally mandated paid leave, and includes people who don’t typically get such benefits, like part-time and gig economy workers. But the measure excludes at least half of private-sector workers, including those at the country’s largest employers, and gives small employers significant leeway to deny leave.The coronavirus emergency relief package gives many American workers paid leave if they need to take time off because of the virus. It gives qualified workers two weeks of paid sick leave if they are ill, quarantined or seeking diagnosis or preventive care for coronavirus, or if they are caring for sick family members. It gives 12 weeks of paid leave to people caring for children whose schools are closed or whose child care provider is unavailable because of the coronavirus. It is the first time the United States has had widespread federally mandated paid leave, and includes people who don’t typically get such benefits, like part-time and gig economy workers. But the measure excludes at least half of private-sector workers, including those at the country’s largest employers, and gives small employers significant leeway to deny leave.
So far, the evidence seems to show it does. A widely cited paper published in April suggests that people are most infectious about two days before the onset of coronavirus symptoms and estimated that 44 percent of new infections were a result of transmission from people who were not yet showing symptoms. Recently, a top expert at the World Health Organization stated that transmission of the coronavirus by people who did not have symptoms was “very rare,” but she later walked back that statement.So far, the evidence seems to show it does. A widely cited paper published in April suggests that people are most infectious about two days before the onset of coronavirus symptoms and estimated that 44 percent of new infections were a result of transmission from people who were not yet showing symptoms. Recently, a top expert at the World Health Organization stated that transmission of the coronavirus by people who did not have symptoms was “very rare,” but she later walked back that statement.
Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks.Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks.
A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study.A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study.
The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April.The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April.
Mass protests against police brutality that have brought thousands of people onto the streets in cities across America are raising the specter of new coronavirus outbreaks, prompting political leaders, physicians and public health experts to warn that the crowds could cause a surge in cases. While many political leaders affirmed the right of protesters to express themselves, they urged the demonstrators to wear face masks and maintain social distancing, both to protect themselves and to prevent further community spread of the virus. Some infectious disease experts were reassured by the fact that the protests were held outdoors, saying the open air settings could mitigate the risk of transmission.Mass protests against police brutality that have brought thousands of people onto the streets in cities across America are raising the specter of new coronavirus outbreaks, prompting political leaders, physicians and public health experts to warn that the crowds could cause a surge in cases. While many political leaders affirmed the right of protesters to express themselves, they urged the demonstrators to wear face masks and maintain social distancing, both to protect themselves and to prevent further community spread of the virus. Some infectious disease experts were reassured by the fact that the protests were held outdoors, saying the open air settings could mitigate the risk of transmission.
States are reopening bit by bit. This means that more public spaces are available for use and more and more businesses are being allowed to open again. The federal government is largely leaving the decision up to states, and some state leaders are leaving the decision up to local authorities. Even if you aren’t being told to stay at home, it’s still a good idea to limit trips outside and your interaction with other people.States are reopening bit by bit. This means that more public spaces are available for use and more and more businesses are being allowed to open again. The federal government is largely leaving the decision up to states, and some state leaders are leaving the decision up to local authorities. Even if you aren’t being told to stay at home, it’s still a good idea to limit trips outside and your interaction with other people.
Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days.Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days.
If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.)If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.)
Taking one’s temperature to look for signs of fever is not as easy as it sounds, as “normal” temperature numbers can vary, but generally, keep an eye out for a temperature of 100.5 degrees Fahrenheit or higher. If you don’t have a thermometer (they can be pricey these days), there are other ways to figure out if you have a fever, or are at risk of Covid-19 complications.Taking one’s temperature to look for signs of fever is not as easy as it sounds, as “normal” temperature numbers can vary, but generally, keep an eye out for a temperature of 100.5 degrees Fahrenheit or higher. If you don’t have a thermometer (they can be pricey these days), there are other ways to figure out if you have a fever, or are at risk of Covid-19 complications.
The C.D.C. has recommended that all Americans wear cloth masks if they go out in public. This is a shift in federal guidance reflecting new concerns that the coronavirus is being spread by infected people who have no symptoms. Until now, the C.D.C., like the W.H.O., has advised that ordinary people don’t need to wear masks unless they are sick and coughing. Part of the reason was to preserve medical-grade masks for health care workers who desperately need them at a time when they are in continuously short supply. Masks don’t replace hand washing and social distancing.The C.D.C. has recommended that all Americans wear cloth masks if they go out in public. This is a shift in federal guidance reflecting new concerns that the coronavirus is being spread by infected people who have no symptoms. Until now, the C.D.C., like the W.H.O., has advised that ordinary people don’t need to wear masks unless they are sick and coughing. Part of the reason was to preserve medical-grade masks for health care workers who desperately need them at a time when they are in continuously short supply. Masks don’t replace hand washing and social distancing.
If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.
If you’re sick and you think you’ve been exposed to the new coronavirus, the C.D.C. recommends that you call your healthcare provider and explain your symptoms and fears. They will decide if you need to be tested. Keep in mind that there’s a chance — because of a lack of testing kits or because you’re asymptomatic, for instance — you won’t be able to get tested.If you’re sick and you think you’ve been exposed to the new coronavirus, the C.D.C. recommends that you call your healthcare provider and explain your symptoms and fears. They will decide if you need to be tested. Keep in mind that there’s a chance — because of a lack of testing kits or because you’re asymptomatic, for instance — you won’t be able to get tested.
In contrast to most available sleep medications, melatonin seems not to be habit-forming and typically produces no hangover effects.In contrast to most available sleep medications, melatonin seems not to be habit-forming and typically produces no hangover effects.
Before you buy melatonin, it’s important to make sure you are getting it from a reputable place. “The F.D.A. does not regulate supplements,” Dr. Kolla said. “So you’re trusting the manufacturer in terms of the dosing.”Before you buy melatonin, it’s important to make sure you are getting it from a reputable place. “The F.D.A. does not regulate supplements,” Dr. Kolla said. “So you’re trusting the manufacturer in terms of the dosing.”
A 2017 study in the American Academy of Sleep Medicine found that the melatonin content of dietary supplements often varies widely from what is listed on the label. The study found that even within the same batch of product, variability of the melatonin varied by as much as 465 percent.A 2017 study in the American Academy of Sleep Medicine found that the melatonin content of dietary supplements often varies widely from what is listed on the label. The study found that even within the same batch of product, variability of the melatonin varied by as much as 465 percent.
Without governmental oversight, there really isn’t a way to ensure the levels of melatonin advertised on the package are accurate. Therefore, Dr. Kolla recommends looking for a GLP (good laboratory practice) or GMP (good manufacturing practice) label on the product. Both labels refer to federal regulations designed to affirm a product has the quality and purity that appear on its label. He says this provides “some assurance that you are getting close to what the label says you’re getting.”Without governmental oversight, there really isn’t a way to ensure the levels of melatonin advertised on the package are accurate. Therefore, Dr. Kolla recommends looking for a GLP (good laboratory practice) or GMP (good manufacturing practice) label on the product. Both labels refer to federal regulations designed to affirm a product has the quality and purity that appear on its label. He says this provides “some assurance that you are getting close to what the label says you’re getting.”
Taking melatonin supplements alone to treat insomnia won’t be as effective as taking melatonin and also working on improving your sleep hygiene, Dr. Avidan said. Sleep hygiene refers to creating an ideal environment that promotes conditions good for sleep.Taking melatonin supplements alone to treat insomnia won’t be as effective as taking melatonin and also working on improving your sleep hygiene, Dr. Avidan said. Sleep hygiene refers to creating an ideal environment that promotes conditions good for sleep.
These include:These include:
Powering down electronics and avoiding the news two hours before bedtime.Powering down electronics and avoiding the news two hours before bedtime.
Maintaining a regular sleep schedule.Maintaining a regular sleep schedule.
Eschewing alcohol and caffeine at night.Eschewing alcohol and caffeine at night.
Trying to get as much natural sunlight during the day as possible to orient your internal clock.Trying to get as much natural sunlight during the day as possible to orient your internal clock.
Dr. Avidan suggests that people both try these habits and take melatonin for two to three weeks to see if it helps.Dr. Avidan suggests that people both try these habits and take melatonin for two to three weeks to see if it helps.
While melatonin “can help with the promotion of sleep, for many it does not,” Dr. Salas said.While melatonin “can help with the promotion of sleep, for many it does not,” Dr. Salas said.
If you are stumped as to why melatonin isn’t working for you, Dr. Salas recommends talking to your physician. She says it may also be time to contact a sleep specialist, as there could be other, more serious sleep issues. Dr. Avidan says he and his colleagues are currently taking virtual appointments for anyone living in the United States, so it’s worth inquiring whether a sleep specialist can see you remotely.If you are stumped as to why melatonin isn’t working for you, Dr. Salas recommends talking to your physician. She says it may also be time to contact a sleep specialist, as there could be other, more serious sleep issues. Dr. Avidan says he and his colleagues are currently taking virtual appointments for anyone living in the United States, so it’s worth inquiring whether a sleep specialist can see you remotely.