Persoonlijk denk ik dat je beter naar de huisarts kunt gaan. Een kennis van mij heeft Seroquel voorgeschreven gekregen voor precies dezelfde problematiek. Nu wil ik niet de suggestie wekken dat jij hetzelfde moet gaan nemen maar op z'n minst in gesprek gaan met je huisarts over deze problematiek is wellicht verstandiger dan op eigen houtje dingen te gaan proberen. Gezien de negatieve aspecten van langdurig benzo gebruik zou ik het je persoonlijk niet aanraden om het voor langertermijn te gaan gebruiken. Recent is er bijvoorbeeld nog een onderzoek uitgekomen over
benzodiazepine gebruik in ouderen waarbij de kans op het krijgen van alzeheimer toeneemt (mocht je tot de populatie ouderen behoren).
De studie die je aanhaalt gaat over ouderen en de sample size is erg klein (21). Ik weet je leeftijd natuurlijk niet maar melatonine productie neemt af naarmate men ouder word. Vandaar dat problematiek met slaap vaker voorkomt bij ouderen. Of hetzelfde op gaat voor andere jongere populaties is dan nog de vraag. Immers zou jouw insomnia problematiek een andere oorzaak kunnen hebben.
Dat je goede resultaten zou kunnen behalen met deze combinatie zou (deels) ook te maken kunnen hebben met het
placebo effect. Bewustzijn van het placebo effect hoeft trouwens niet te betekenen dat het placebo effect niet meer werkt. In een dergelijk geval is het wellicht dan toch verstandiger om een suiker pil of iets dergelijks te regelen
Ik begrijp je redenering wat betreft verschillende resultaten combineren maar onze lichamen zijn zeer complex. Individuele bevindingen van studies hoeven niet altijd in combinatie met elkaar de resultaten te produceren zoals die individueel bevonden worden. Wetenschappelijk gezien zou het wel interessant kunnen zijn op basis van bevindingen van studies een hypothese te vormen en daarna het te gaan onderzoeken. Het uitsluiten dat deze combinatie werkt kan ik dus ook niet.
Mijn indruk van Melatonine is in ieder geval dat het wederom door de supplementen industrie aangeprezen word als een wondermiddel op basis van een beperkte basis aan wetenschappelijkbewijs.
Conclusion: There is sufficient evidence that low doses of melatonin improve initial sleep quality in selected elderly insomniacs. However, larger randomized controlled trials, with less strict inclusion criteria are necessary to yield evidence of effectiveness (i.e. clinical and subjective relevance) in geriatric patients who suffer from insomnia, before wide-spread use can be advocated.
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Melatonin in elderly patients with insomnia. A systematic review. (2001)When consumed orally, melatonin is not consistently or extensively absorbed, so individual responses to doses can vary, which complicates dosing. Supplement doses can push blood levels much higher than any levels that can ever been reached naturally. Receptors are highly sensitive to high doses, and their activity decreases as a result, suggesting that long-term supplementation may have unanticipated consequences. It appears to have a good short term safety profile, however, and toxicity reports are rare. Supplement doses range from 0.1 – 10mg with most doses at the lower end of this scale.
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There is also no information to suggest that different brands are equivalent to each other. Given melatonin is inconsistently absorbed, switching brands may affect absorption, and ultimately, effect.
The evidence
Melatonin supplementation does appear to have effects on sedation, fatigue, time to fall asleep and the total sleep duration. Studies are hard to synthesize, given they include big range of doses, a variety of dosing schedules, and a wide number of underlying conditions. The best evidence seems to be for circadian sleep disorders, where melatonin has FDA orphan drug status for this use. Based on the physiologic effects of melatonin, this makes some sense.
For general sleep disorders, the evidence is mixed. There is some tentative support for use in children, however the evidence base used to make this claim is based on an analysis of six small clinical trials, only one of which was in children with sleep disorders without other contributing cause or underlying medical issue (e.g., behavioral disturbances).
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In adults, a 2005 meta-analysis suggested that melatonin would reduce the time to fall asleep by four minutes, while increasing total sleep duration by 13 minutes. Another 2005 meta-analysis drew a similar conclusion: melatonin was well tolerated but not very effective, improving the time to fall asleep by 12 minutes. A 2006 meta-analysis looked at secondary sleep disorders, like jet lag and shift work, and concluded that melatonin offered no meaningful benefits beyond placebo. It could be the short half-life of of the supplement that’s a factor. Show release versions or drug-based variants of melatonin (i.e., ramelteon) could plausibly have more meaningful effects.
Despite the array of doses used, melatonin is well tolerated. The most common side effects reported include daytime sleepiness, dizziness and headaches.
Conclusion
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Regardless of its regulatory status, evidence suggests that melatonin is only modestly effective, and many who use it will not show substantive improvements in their sleep quality. What is clear is while there’s nothing “natural” about taking huge doses of this hormone, it is well tolerated when used for short-term trials.
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Sciencebasedmedicine.org - Melatonin for sleep disorders – Safe and effective? (2013)"According to our research, the physiological dose of melatonin of about 0.3 milligrams restores sleep in adults over the age of 50," said Wurtman, lead investigator in the study. "The adults who would normally wake up during the second and third thirds of the night were able to sleep through the night with the 0.3 milligram dosage."
The researchers also discovered that the typical health food store dosage of melatonin, which is about three milligrams (or 10 times the dosage in the study), is less effective in treating insomnia. In addition, the higher dosage can cause potentially serious side effects, including hypothermia (low body temperature). The study also showed that the higher dosage elevated plasma melatonin levels during the day, which can cause a "hangover" effect in some of the subjects.
"Our study has shown that less is more as far as melatonin is concerned," Wurtman said. "Adult patients who suffer from insomnia and are considering melatonin should consult with their doctor about the appropriate dosage. We have demonstrated that with the correct dosage, melatonin can help an older person experience a restful and uninterrupted night of sleep."
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Scientists pinpoint dosage of melatonin for insomnia (2001)Mistake #2: I can take melatonin at any time.
If melatonin is used during daytime brightness, it can cause adverse effects. If the body clock is receiving conflicting daytime light signals and dark signals from melatonin, it can malfunction and not work properly when it is time to go to sleep later.
Mistake #5: I need to keep taking melatonin.
Sleep experts don’t recommend taking melatonin for more than two weeks at a time. Melatonin is effective as a signal augmenter (reinforcing external cues), or as a tool to help shift sleep and circadian rhythms. Long term use of melatonin indicates a more serious underlying sleep disorder that should be investigated by a sleep professional.
Mistake #6: The dosage amount isn’t important.
The problem with melatonin is that it was discovered long before scientists really understood what it does and how much you need. For example, in the late 80′s and early 90′s, we thought melatonin was a sleep hormone. Now we know it is much more complicated. In addition, tablet sizes average 3-5 mg. New evidence shows that adult males only need 150 micrograms, and the average female needs only 100 micrograms (a microgram is 1/100 th of a milligram). So the average melatonin supplement is 20 – 50 times more than we need! If you are using regular melatonin tablets, you can cut the pill into fourths, otherwise, try to find the smallest pill size available. If you are taking time-released melatonin, do not break the pill, as this will ruin the time-release.
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Talkaboutsleep.com - How to Use Melatonin Correctly“Scientists do not speak in absolutes, they present the results that support the hypothesis and the tolerance for error.”
Het kan dus ook vanaf lagere doseringen al een invloed hebben op dromen en mogelijk andere aspecten.
