Melatonin, Dr Yacoob Omar Carrim

Melatonin - has rapid, transient, mild sleep inducing effects and lowers alertness and body temperature during the 3-4 hours after low dose
Eastward travel - early evening (6 pm) treatment before departure for 3 to 4 days and melatonin at bedtime.
Westward travel - melatonin for 4 days at bedtime (11pm or later) - dont take melatonin before you fly.

Shiftworkers - early morning melatonin treatment improves daytime duration and quality if sleep and nighttime alertness. Maybe used to aid afternoon sleep.

Other: Timed exercise, Vit B12 - sensitises the circadian system to light induced phase shifts.

Shift work - basic principles

Sleep - Jet Lag - Dr Yacoob Omar Carrim

Sleep - Jet Lag and other circadian rhytm disorders

Other Circadian disorders

• Shift work sleep disorder
• circadian sleep-wake disorder of blindness

Symptoms

• Disrupted female mestruation cycle - female flight attendents
• Meals eaten out of phase - result in inappropriate pancreatic and metabolic responses and may be long term risk factors for heart disease
• Life span can be shorterned by phase shifting

SWSD - shiftworkers - sleep problems, GIT problems, metabolic syndrome, heart disease and cancer

Suprachiasmic nucleus of the hypothalamus

• Central pacemaker

Melatonin, light, body temperature

Management:
Sleep hygine

• reduce noise, unwanted stimuli, earplugs, eye patches
• avoid alcohol and caffine
• jet leg diet - carbs at night for seratonin synthasis and protien in the day - thyrosine, catacholamine production
• Naps
• Hypnotic agents - short acting "Z" drugs
• Light - Lab studies - 460 to 465 nm (Blue); field studies

Melatonin: produced at night for the duration of the night. ? effect on reproduction

Dr Yacoob Omar Carrim
zasleep@gmail.com

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Circadian Factors - Dr Yacoob Carrim

Enviromental zertgeber effects of:

• bright light 3000 Lux (suppresses melatonin)
• Bedroom light proofing
• Welders sunglasses on commute home from night work

Enhance circadian adjustment - Rx Melatonin

• ? effect on enhancing daytime sleep

Humans are diurnal - work in the day and sleep at night
Circadian alignment affects mood, well being and performance efficiency
Circadian reallignment leads to desynchronosis

• Malaise, gastrointestinal dysfunction, performance decrements

Sleep Factors

• Shift workers get 10 hours less sleep per week
• - less S2 and REM. SWS is consistant. reduced sleep latency
• Drive home from night shift - most dangerous activity
• Domestic and social factors
• - childcare
• - hosehold maintenance functions
• - risk of divorce 57%
• -- sexual partner, social companion, protector and caregiver roles are compromised
• Social isolation from daywork friends, religious and community organisations

Dr Yacoob Omar Carrim
zasleep@gmail.com