I talk a lot about melatonin, because for sleep and overall health, melatonin is a major player.
What makes melatonin so powerful for our health?
Melatonin is a regulator of circadian rhythms. By keeping the circadian clocks and rhythms in sync, melatonin enables regular sleep-wake cycles (and with them, sound, refreshing sleep). So much of the body’s daily activity is tied to circadian timing—everything from metabolism and appetite to immunity and cognition—which means melatonin’s circadian-regulating power has widespread benefits for health and functioning beyond sleep.
A powerhouse antioxidant, melatonin protects cell health and helps limit the damage from free-radical cells. It’s also a potent fighter against the growth and spread of cancer cells. And melatonin delivers specific and important protection to the brain.
We all want to sleep well, slow the effects of aging, and maintain our brain health and cognitive skills for the entirety of our lives. Melatonin has a pivotal role to play in all those things.
A key source of melatonin production occurs in the brain’s pineal gland. And it’s the pineal gland I’m going to talk about today, because changes to that very small, very important area of the brain affect how much melatonin our bodies produce, with potentially significant effects on the aging process, and our risk for neurodegenerative disease, including Alzheimer’s.
Pineal melatonin matters to sleep, aging, and brain health
The pineal gland, roughly the size of a pea, is located in roughly the exact center of the brain. While this tiny gland produces several different neurochemicals and hormones that affect physiological health and functioning, melatonin is its most significant product. Melatonin IS made elsewhere in the body—in fact, we know from relatively recent research that melatonin can be produced in most of the body’s cells. Significant amounts of melatonin production occurs in the gut, and melatonin is also made in skin cells, blood cells, and brain cells beyond the pineal gland.
But the melatonin that’s made by the pineal gland is unique and distinctly important. It’s this specific, pineal-derived melatonin that regulates circadian rhythms. Pineal melatonin production is triggered by darkness. The rise in pineal melatonin functions as a signal to the master circadian clock that keeps the master clock synchronized for the roughly 24-hour daily cycle of activity it oversees.
When the pineal gland can’t function optimally, this critical supply of melatonin is disrupted. And disruption of this circadian-signaling melatonin can lead to serious negative consequences for sleep, for biological aging, and for the risk of neurodegenerative diseases including Alzheimer’s.
One way the pineal gland loses normal functioning is from a process known as calcification. Calcification is the build-up of calcium deposits. Calcification occurs in many areas of the body, including the heart and the arteries, the brain, and in joints and muscles. But the pineal gland is especially vulnerable to calcification. In fact, calcification happens more aggressively in the pineal gland than in any other place in the body.
Melatonin protects brain health and slows aging process
Melatonin’s role in offering protection for brain health and functioning is well documented. Among melatonin’s many functions in the body, it serves as an anti-inflammatory and anti-oxidant. The brain is particularly vulnerable to damage from inflammation and oxidative stress, and keeping melatonin levels up can help reduce that damage. Melatonin also works directly to prevent the formation of two proteins—tau and beta-amyloid—that are key biological markers of Alzheimer’s disease. We benefit from a robust supply of melatonin over the span of our lifetime to maintain healthy cognitive function and lower our risk for developing Alzheimer’s.
There is promising research showing that melatonin may be an effective treatment for Alzheimer’s. Studies show that melatonin can slow the progression of Alzheimer’s and reduce symptoms associated with the disease, including sleep disruptions, cognitive decline, and sundowning, which is the increased confusion and agitation that happens late in the day in some people with dementia.
Alzheimer’s is not the only neurodegenerative disease that can be influenced by melatonin. Research indicates that melatonin may help in the treatment of Parkinson’s, ALS, multiple sclerosis, and Huntington’s disease.
Melatonin also has broad effects on overall biological aging. Melatonin levels drop with age—that’s something that happens independently of pineal calcification. Low melatonin levels are associated with an acceleration of biological aging. Disruptions to the circadian system are critically involved in aging and affecting longevity, and low melatonin levels make the circadian system work less effectively. Of course, low melatonin levels and out-of-sync circadian clocks also contribute directly to sleep problems, which also affect aging. There’s research in animals that shows boosting melatonin levels can extend lifespan.
Calcification in the pineal gland interferes with melatonin production, elevating risks for neurodegenerative disease, accelerating aging, and making sleep disruptions more common and more severe. But the impact of pineal calcification to aging and disease goes beyond the loss of melatonin. Research has shown us that pineal calcification itself is associated with aging and with Alzheimer’s.
Let’s recap here: pineal calcification hinders melatonin production, which speeds aging and deprives the brain of protection against the development of Alzheimer’s disease and other neurodegenerative diseases. Beyond interfering with melatonin, pineal calcification also may directly influence accelerated aging and risk for neurodegenerative disorders.
That leads to a big question: can we take steps to reduce pineal calcification, to protect sleep, brain health, and longevity?
Can we slow pineal calcification with better sleep?
Scientists still have a lot to learn about how pineal calcification happens, and how this calcification affects aging and contributes to neurodegenerative diseases such as Alzheimer’s. But there is evidence of some of the factors that may contribute to calcification. That research gives us a basic blueprint for steps we can take that may limit and slow calcification of the pineal gland, and disruptions to healthy melatonin. And here’s where things get really interesting—because sleep itself can help address at least some of the factors that scientists think may accelerate calcification.
Chronic vascular inflammation. The pineal gland is packed with arteries, veins and capillaries, and it undergoes an extremely high rate of blood flow. That makes this gland particularly vulnerable to vascular inflammation. And research shows this form of inflammation may trigger calcification. Sleeping well—both getting enough sleep and making sure sleep is restorative, is one important way to limit chronic inflammation, especially as we age. Here are 5 key things to know about the relationship between sleep and inflammation.
Other anti-inflammatory habits? Staying at a healthy weight, getting regular exercise, eating a whole food diet low in processed foods and sugar. Those habits have the added benefit of helping to improve sleep, too! Here’s what to know about how sugar interferes with healthy sleep. And here’s a primer on the benefits of exercise to sleep.
Hypoxia in the brain. Hypoxia is a lack of oxygen supply. Brain hypoxia occurs when the brain is deprived of adequate oxygen. Hypoxia in the brain may contribute to the build-up of calcium deposits in the pineal gland. You’ve heard me talk about hypoxia a lot in relation to one of the most common and problematic sleep disorders: obstructive sleep apnea. The impaired breathing of sleep apnea deprives the brain of adequate oxygen. Hypertension also leads to brain hypoxia. Both of these conditions go frequently un-diagnosed, leaving people exposed to the harmful effects of hypoxia. By diagnosing and getting treatment for sleep apnea and high blood pressure, we reduce the risks of insufficient oxygen supply to the brain—and this may help reduce calcification in the pineal gland.
In recent research, sleep apnea has now been directly linked to accelerated aging. And there’s also significant evidence that the disruptions to sleep and oxygen levels from sleep apnea may contribute to greater risk for Alzheimer’s disease. I’ve written before about how treating sleep apnea can offer protection against the effects of aging, and specific protection against Alzheimer’s.
There’s some fascinating science underway that’s exploring ways to de-calcify and rejuvenate the pineal gland. But we all can take steps in our daily lives to keep this melatonin-making gland healthy and functioning well. And those steps start with improving our nightly sleep.
Questions about taking melatonin
I get a lot of questions from people about whether they should take melatonin for sleep, and to supplement their body’s natural melatonin production. Supplementing with melatonin can be useful for some people, but BEFORE you add melatonin to your supplement regimen, it’s important to understand whether melatonin is right for you, and to know how much to take, and when to take it.
Melatonin levels decline for several reasons, and aging is only one of them. Medical conditions, genetics, ill-timed light exposure, and changes to daily schedules are other factors that contribute to low melatonin.
And melatonin deficiency is only one potential explanation for difficulty falling asleep and irregular sleep routines that deprive you of a sufficient amount of restorative sleep to meet your individual needs. Trouble falling asleep, waking throughout the night, feeling exhausted and unrefreshed, having trouble concentrating during the day—these common sleep problems can occur as the result of any number of lifestyle and health factors, as well as from sleep disorders that exist independent of a melatonin deficiency.
The main takeaways? Melatonin, at the right dose, can help many people fall asleep more quickly. But there isn’t clear evidence about whether melatonin improves overall sleep and sleep quality. Melatonin is frequently effective for short-term use for jet lag. For insomnia symptoms, melatonin is most effective when used in combination with other sleep-boosting methods, including other natural sleep aids, changes to your sleep environment and to daily and nightly routines–for example, using blue-light-blocking glasses for screen time in the evenings.
The factors that contribute to our disrupted sleep, and to low melatonin levels, are multiple and differ from one individual to the next. There’s no one-size-fits-all answer to whether you ought to be taking melatonin.
I advise that everyone’s first step be a discussion with your doctor. To assess a possible deficiency, melatonin levels can be tested through a blood, saliva or urine test, and your doctor can determine which test is right for you. While there are at-home melatonin level tests available, in order to assure you’re getting accurate results, if you’re seeking to have melatonin levels tested it’s important to do this through your physician. Equally important is the opportunity for your physician to work with you to diagnose any underlying medical conditions, including the presence of a sleep disorder.
If you are taking melatonin for sleep, in consultation with your doctor, it’s important to pay attention to the timing of your nightly dose. It can take some adjusting to time your dose so its effects peak at the right time. If you take melatonin too early, it will kick in too soon, and if you take it too late, you may feel groggy the next morning. I recommend starting by taking melatonin about 2 hours before bedtime and adjusting your timing in 30-minute increments until you’re falling asleep consistently at your designated bedtime and waking without excessive drowsiness. (You can use my bedtime calculator to determine your optimal bedtime.)
How much melatonin should you take? If you’re taking melatonin in pill form, I recommend taking 0.5 mg to 1.5 mg about 90 minutes before bed. If you’re taking melatonin in liquid form, take that same dosage but half an hour before bedtime.
My Sleep Doctor PM formula comes in two formulas, one for the beginning of the night and another for the middle of the night. The beginning of the night formula contains melatonin to help you fall asleep but the middle of the night formula does not so that you are able to get back to sleep without waking up with groggy side effects.
Michael J. Breus, PhD, DABSM
The Sleep Doctor™