MELATONIN-HORMONE OF SLEEP-CORRECTING SLEEP DISORDERS

  SLEEP DISORDERS AND TREATMENTS

                           A good night's sleep indicates that our body is in good health.

Insomnia is the condition in which a person is hardly getting sleep.

Generally, our brain controls all activities of our body including wake and sleep.

The pineal gland is an endocrine situated deep in the centre of the two halves of our brain.

Melatonin is synthesized by the pineal gland from the neuronal excitatory hormone known as 5-hydroxytryptophan (5HT3) or serotonin. Melatonin is chemically known as N-acetyl-5-methoxy tryptophane or roughly be called as acetyl methoxy tryptophane.

Melatonin is not a sleeping medicine like some antihistamines, gabaergic, or anticholinergic. But it helps a person to fall asleep by induction and regulating sleep patterns like the circadian clock.

When darkness fell the room our natural circadian rhythm reaches the mood of asleep. This is induced by our third eye known as the pineal gland by releasing melatonin into our blood.

Melatonin helps our body to identify the time for sleep when lights went off and darkness gets in.

Melatonin helps our body to prepare for sleep by relaxation, decreased respiration, and body temperature, yet it is not a sleeping drug. Melatonin does not keep you dull or sleepy.

When the sun rises in the morning our eyes detect light and our third eye the pineal gland reduces the secretion of melatonin. Melatonin preparations are available in the market as food supplements.

One can use it with the following precautions. Because overdosage and overtime use may produce side effects.

Melatonin can be used safely for 1 year for continuous use. After that one should put at least a three-month gap.

Melatonin can be dosed from 05 to 10 milligrams according to the person's needs.

05 mg may give a person to sleep for 1 hour while 10 mg may give you 7 to 10 hours of sleep. A low dose is always safe.

Melatonin is having other advantages also such as fat loss, muscle gain, improved metabolism, and muscle protection. It prevents muscle waste.

Melatonin does not keep a person asleep but it will induce sleep.

On overdose melatonin actually, reset your circadian clock and your sleep pattern will be changed.

The Science of Sleep:-

Our body has its own sense of rhythms known as circadian rhythmic cycles in a 24 hour day time. These cycles are involved by the secretions of various chemicals and activities to schedule our body's various daily programs such as what to do and when to do. These circadian cycles are actually known as the Mind in Mind. This In Mind has to be prepared or to be consulted by our mind before scheduling any program.

For example, if a person has got an engagement in the morning for that he set his alarm to wake him up at 6 o'clock in the morning. But when the alarm rings at 6 a.m the person cannot get up and his mind and mood will not cooperate with him to get up to attend the scheduled program.

This is because his mind did not consult or programmed the In Mind or the circadian clock accordingly.

Melatonin is one of the chemicals involved in the circadian rhythms to schedule our sleep time when darkness falls. Melatonin tells our body to go to bed because it is time for sleep when your bedroom becomes dark.

This circadian cycle starts from the brain's suprachiasmatic nucleus which is situated at the centre of the brain. At the sunrise in the morning when light fills the bedroom the suprachiasmatic nucleus sends circadian signals down to the spine. The body sets the program ready for the day. When the light falls on the eyes the retina sends back the signals to the suprachiasmatic nucleus which in turn commands the pineal gland to reduce melatonin release. In the evening when the light dims and darkness falls on the retina again signals go to the pineal gland through the suprachiasmatic nucleus to increase the melatonin release into the blood and the cerebrospinal fluids. The presence of melatonin attains its peak at midnight. Normal sleep starts. This is the science of sleep. Any disturbance to this science may result in normal sleep disorders.

Side Effects: -Side effects are few as follows.

1.Headache

2.Short Depression

3.Sleepiness, somnambulant

4.Dizziness

5.Stomach pain

6.Hypothermia

7.Bedwetting in Children

8.Day time drowsiness in adults.

Do not drive at least for 4 hours after taking melatonin.
Merits:-
Melatonin is safer than clonazepam in patients with Parkinson Disease
Melatonin is graded as a food supplement and not a sedative by the FDA because it works entirely in a different pathway.
Melatonin by itself is a derivative of serotonin a hormone of peace and an excitatory neurotransmitter. Sedatives and sleeping pills are working through Gamma Amino Butyric Acid (GABA) pathway which is a neuronal inhibitory pathway.
Of course, serotonin is an excitatory neurotransmitter it is not as powerful as the catecholamines and hence it is not hormone of stress.
Similarly, serotonin has some inhibitory effects on some nerve synapses but not as strong as GABA and hence it would not produce much drowsiness and sedation.
Comparisons:-
GABA-ergic sleeping medicines like benzodiazepines such as alprazolam,midazolam,nitrazepam and diazepam may cause more sedation and respiratory depressions.
GABA-ergic neuroleptics like Gabapentin, Pregabalin are all producing fatal drowsiness and sedation
In addition, all of the above drugs can cause addiction.
But melatonin is very safe and free from all the above drawbacks as it is based on serotonin

Contraindications:-
Do not take sedatives like diazepam or zolpidem with melatonin
Do not take omeprazole like PPI medicines.
Do not take anticoagulants like aspirin, clopidogrel, or warfarin along with melatonin.
Do not take diclofenac like pain killers along with melatonin.
Consult with a neuro specialist before taking this medicine.

SELF HEALTH CHECK-UP-CHECK YOUR B.P AT HOME BY YOUR SELF-II

HOW TO USE MANUAL B.P METERS

Both manual and electronic meters use oscillometric methods to measure B.P.
There are two types of manual meters
1.Aneroid
2.Mercury

But they are quite different when we handle them. Digital electronic meters are very sensitive and need many precautions to have precise readings. They need repeated measurements to get satisfactory results. But mechanical and manual meters such as mercury and aneroid meters are very convenient in handling and needless precautions to get results satisfactorily with a single measurement. In this method patient's movements do not disturb the accuracy. Albeit their easiness to handle they have their own disadvantages.

span style="font-size: x-large;">When using manual meters one should be familiar with the so-called KOROTKOFF sounds that can be heard through a stethoscope. This is the correct auscultatory method of B.P measurement.

In the following diagram there are 5 sounds that can be heard which are represented by 5 blue unequal straight lines.

During measurements distinguishing these sounds are very important to get an accurate result. This can be possible through experiences of using a stethoscope.

Method

Preparations for the measurement are similar to the electronic methods with relaxation and easiness while sitting on a chair.

The table height is not very important but it must be inconvenient.

It is not a must to keep the cuff sensor in a straight line with the heart.

1. Put the arm with fingers relaxed on the table.

2. Place the cuff around your elbow and tight it.

3. Place the bulb of the stethoscope on the brachial artery of your upper arm-elbow joint and inflate the cuff to just above your assessed systolic pressure. Allow the cuff to deflate slowly.

4. Carefully watch the five Korotkoff sounds as follows:-

          1.The first clear weak sound that slowly increases

           2.The second stronger and clear sound but still somewhat weaker than the 3rd sound.

           3.The clear strong sound that approaches the peak. At this point stop the deflation and note down the reading-Systolic Pressure.

           4. Allow to further deflate and note down the sound gets weaker and weaker

           5. The final fifth swashing and murmuring sound follows and disappears at a point. Stop the deflation and note down the reading-The diastolic Pressure

In this manual method Pulse, reading cannot be measured.

SELF HEALTH CHECK-UP-CHECK YOUR B.P AT HOME BY YOUR SELF-I

KNOW HOW TO MEASURE B.P BY YOURSELF

    Our overall health is based on many parameters out of which blood pressure is one of them. Our daily blood pressure varies every second according to our daily activities and situations which we face every day. Emotional environments at home as well as in our workplace play an important role to deal with our normal blood pressure. Social activities such as sports, games, friendships, and enmities play another role to deal with our blood pressure.

For an employer the B.P. rises and falls whenever he deals with his business's profits and losses.

A student's B.P.is highly sensitive when he is in the examination hall.

A criminal's B.P.goes beyond the control when he is on the run and as well as when he is caught up.

The B.P flares up during when a criminal faces his death sentence at the gallows.

On the other side the abnormal fluctuations in the blood pressure affect many of our body organs and their normal functions.

Important organs such as our brain, kidney, liver eyes, and our visceral organs such as our digestive organs are all affected by the variation in the blood pressure.

Catecholamines such as adrenaline, noradrenaline, and dopamine activities predominate when a person is at stress. His B.P.rises, his heartbeat increases, and the blood supply to various organs such as the brain, kidney, and liver get reduced and finally our overall health is jeopardized.

Hence every day or at least weekly once checking your pressure is very important to lead a healthy life.

There are many types of B.P. apparatuses are available in the market to check your B.P at home by yourself.

They are manual, semi-automatic, and automatic.

They are mechanical and as well as electronic.

Electronic and mechanical instruments both use oscillometric methods.

An oscillometric method is one which measures blood pressure oscillations at the area in which blood circulation is blocked or cuffed and released. The area is usually at the upper arm or wrist. When a cuff is placed around the upper arm or wrist and inflated to tight around the arm the blood gets occluded in that area. When the cuff is deflated the blood begins to flow again by making the walls of the artery on that area more vulnerable to oscillate which is more pronounced to measure either by digitally or by mechanical sounds which can be heard by a stethoscope.
There are two methods of assessing your B.P.
1.Palpable Method in which you can assess your systolic pressure by counting the number of palpitation at the wrist artery exactly below the inner side of your thump. But by this method you cannot assess the diastolic pressure. Palpable methods can be done at the wrist radial artery.
2.Oscillatory or Auscultatory Method in which both the systolic and diastolic pressures can be measured satisfactorily by using instruments. This method can be performed conveniently on both the wrist radial artery as well as the arm-elbow brachial artery.

Preparations For B.P.Measurements:-

                           

Get ready with your instrument by removing it from its package. Fit the inflating cuff with its plugged with the monitor properly. The monitor should be connected with the A/C electrical outlet. Ensure the correct voltage mentioned at the bottom of your instrument. Otherwise use batteries.

The best time to measure B.P.is morning soon or one hour after you get up from your bed before taking tea or coffee on an empty stomach. Morning pressure is an important indicator of your normal health. Morning B.P.measurement can be comfortably done if you have your own B.P.kit at your home otherwise you must be an inpatient in a hospital.

2.Sit in a chair comfortably and rest your back at the chair. Relax for 10 minutes and keep your two feet apart from each other.

3. The monitor must be placed comfortably on a table so that the height of the table should be just below your heart or chest and the monitor should be on a straight line with your heart.

4.If you are a right-handed man use your left hand for measurements and vice versa

5. Put the cuff around your arm properly and tight it around the arm so that your index finger can be inserted. Too much tightness or too loose may give you wrong readings. The stethoscope bulb is in a straight line with your heart.

6. Again relax for five minutes. The room should be properly ventilated and should be calm. Avoid speaking or hearing music.

7. Press the start button. If your instrument is automatic it inflates automatically and when it reaches the point above your assessed systolic pressure it stops and deflates immediately. When it completes deflation the monitor will show three readings. The upper reading is the systolic pressure which should be normally 110 to 120 m.m.

The middle reading is the diastolic pressure which should be around 75 to 85 m.m

The lower reading is the pulse measurement which should be around 65 to 75.

If your instrument is not automatic inflate the cuff manually by a bulb pump just above your assessed systolic pressure and allow it to deflate.

8. Repeat it two times with half an hour gaps.

9. Take an average reading
10.If you take at least 5 readings that is better. Out of the 5 readings assess the B.P as follows.
For examples out of five tests you may get 5 readings as follows:-
110/80;130/80;130/85;120/80;130/80
You can assess the correct reading out of the five as follows:-
Mode:-The most frequently occur reading-130/80
Median:-The middle reading or average of the middle readings-130/80
The Mean:-Average readings of all the five readings-124/81

What are systolic and Diastolic Pressures?

Systolic pressure occurs when your left ventricle squeezed and loads the blood into the aorta- the main trunk of the artery- the afterload scenery.

Diastolic pressure occurs when the ventricles relax and to receive purified blood from the pulmonary vein.-The preload scenery.
There are many types of B.P kits are available. You can choose from a standard company.