From the Guidelines
Your sleepiness despite being a rapid melatonin metabolizer is likely due to underlying sleep disorders, circadian rhythm disruptions, or other health conditions unrelated to your genetic profile, and improving sleep hygiene and evaluating other potential causes is crucial. While your CYP1A2 variants (-163C>A - C/A, 5347C>T - C/T) suggest you metabolize melatonin more quickly than average, this doesn't necessarily mean your body produces less melatonin naturally 1. Consider the following strategies to address your sleepiness:
- Maintaining consistent sleep-wake times
- Limiting screen exposure before bed
- Creating a dark, cool sleeping environment
- Using timed light exposure to regulate your circadian rhythms, as light can suppress melatonin secretion and phase shift circadian timing in humans, leading to the use of timed light exposure as a treatment for CRSWDs 1
- If melatonin supplements help you, continue using them at the lowest effective dose (typically 0.5-3mg) taken 1-2 hours before bedtime, as the timing of melatonin dosing is more important than the dose, and the melatonin PRC is approximately 180 degrees out of phase with the light PRC 1 Other factors like stress, depression, thyroid issues, or sleep apnea could also contribute to your sleepiness and should be evaluated by a healthcare provider if symptoms persist despite good sleep habits and appropriate melatonin use. It's essential to consult with a healthcare professional to rule out any underlying conditions that may be affecting your sleep and to develop a personalized plan to address your sleepiness.
From the Research
Sleep Disorders and Melatonin
- Sleep disorders are a group of conditions that affect the ability to sleep well on a regular basis and cause significant impairments in social and occupational functions 2.
- Melatonin is an endogenous hormone produced by the pineal gland and released exclusively at night, and it has been shown to synchronize the circadian rhythms, and improve the onset, duration and quality of sleep 2.
Melatonin Metabolism
- The short half-life and rapid metabolism of melatonin limit its suitability as a drug 3.
- As a rapid melatonin metabolizer with CYP1A2 -163C>A - C/A, 5347C>T - C/T, the user's body may be breaking down melatonin quickly, which could contribute to sleepiness if not enough melatonin is available to regulate sleep-wake cycles.
Treatment Options
- Ramelteon, a selective melatonin receptor agonist, has been approved for the treatment of insomnia characterized by difficulty with sleep onset 4, 3.
- Other melatonergic drugs, such as agomelatine and tasimelteon, have also been developed for the treatment of sleep disorders and depression 3.
- Melatonin supplementation is well tolerated and has no obvious short- or long-term adverse effects, but the most suitable dose ranges and pharmaceutical preparations for melatonin administration are yet to be clearly defined 5.
Physiological Effects of Melatonin
- Melatonin is a methoxyindole synthesized and secreted principally by the pineal gland at night under normal light/dark conditions, and its primary physiological function is to convey information concerning the daily cycle of light and darkness to body structures 6.
- The daily melatonin secretion can be used for the organisation of circadian rhythms, and it stabilises and strengthens coupling of circadian rhythms, especially of core temperature and sleep-wake rhythms 6.