David S. Klein, M.D.
Sleep Disorders
One of the many ways of suffering.
Melatonin secretion decreases with age and with administration of opiates (pain-killers.) As melatonin levels decrease, satisfactory sleep becomes more and more difficult.
Melatonin is a hormone found in almost every living creature. Involved in many different physiological systems, melatonin influences sleep cycles, modulates inflammatory pathways, influences gastro-intestinal absorption and influences the immune system. Restoration of adequate melatonin levels is essential for the restoration of satisfactory sleep as well as for permitting the immune system to function normally.
Aging is associated with a decline in immune function, with an associated increased incidence of cancer, infectious disease and autoimmune diseases. A decrease in function of natural killer (NK) cells occurs with age. Circulating melatonin decreases with age as well as with opiate use. Melatonin stimulates the production of progenitor cells for the white blood cell elements, granulocytes and macrophages. Melatonin stimulates the production of NK cells and results in increased production and release of various cytokines from NK cells and T-helper lymphocytes. Melatonin is involved in the regulation of immune function by acting on the immune-opioid network, by affecting G protein-cAMP signal pathway, thereby regulating intracellular glutathione (anti-oxidant) levels.
Melatonin is currently available without prescription, but quality assurance issues are such that careful selection of manufacturer is neccessary to assure that adequate quality and dosages are maintained.
A new prescription medication is available that emulates the effect of Melatonin
ROZEREM™
(ramelteon) tablets
DESCRIPTION
ROZEREM™ (ramelteon) is an orally active hypnotic chemically designated as (S)-N-[2-(1,6,7,8-tetrahydro-2H-indeno-[5,4-b]furan-8-yl)ethyl]propionamide and containing one chiral center. The compound is produced as the (S)-enantiomer, with an empirical formula of C16H21NO2, molecular weight of 259.34, and the following chemical structure:
Interesting Links:
1. Provigil - Useful for those who have difficulty with maintaining a wakeful state.
David S. Klein, MD, FACA, FACPM, FACMIMS
Director, Pain Center of Orlando
www.suffernomore.com