SLEEP SUPPORT

Sleep is essential for good health, yet it is reported that up to 30% of people experience difficulties with falling or staying asleep. (24) One study found the number of people suffering from various sleep disorders has also been on the rise. From the year 2013 to 2016, increases were seen in the prevalence of narcolepsy by 14%, idiopathic hypersomnia by 32%, periodic limb movement disorder by 30%, and rapid eye movement sleep behavior disorder by 64%. (2) 

Sleep disorders can occur as a secondary disease from other disorders or they can be considered the primary disease affecting a patient. A meta-analysis found that patients with anxiety, eating disorders, pervasive developmental, borderline, and antisocial disorders, and schizophrenia all experienced some sort of alteration to sleep. None of the conditions studied had similar polysomnographic profiles, suggesting each condition may have different underlying mechanisms. (6) 

Depending on the factors associated with disturbed sleep, a variety of therapies may be used. Interventions such as sedatives or anxiolytic pharmaceuticals are available; however, the American Academy of Sleep Medicine endorses the use of melatonin, light therapy, and behavioral interventions as the primary treatments. (4) 

The protocol presented below represents research findings to aid in achieving and maintaining good sleep.

Melatonin

2.5 to 3 mg, total per day (at bedtime), minimum three weeks (9)(20)

• All patients with delayed sleep-wake phase disorder (DSWPD) received behavioral sleep-wake scheduling and then split into groups for a 0.5 mg dose of fast-release melatonin or placebo, melatonin decreased patient reported outcomes measurement information system (PROMIS) sleep disturbance, insomnia severity, functional disability, and sleep onset latency by 34 minutes compared to placebo; additionally 52.8% of patients in the treatment group had a more than minimal clinician-rated improvement compared to 24% of placebo, suggesting that while behavioral sleep-wake scheduling scheduling combining with melatonin is much more effective (22)
• A meta-analysis of 12 studies found melatonin efficacious in delaying sleep phase syndrome, and decreasing sleep onset latency in primary insomnia; additionally melatonin was able to regulate sleep-wake patterns in blind patients (5) 
• Pooled data from a meta-analysis and systematic review of 7 studies to be effective for management of secondary sleep disorders as demonstrated by the ability of melatonin to lower sleep onset latency and increase total sleep time (14) 
• Patients with insomnia improved quality of sleep, as well as night before and morning alertness when given 2 mg of prolonged-release melatonin compared to placebo (12)

Valerian