Melatonin and Headaches

Melatonin may be effective for migraine headaches prevention. Compared to a placebo, a 3 milligram dose of Melatonin reduced the number of headache days in migraine patients. According to research results presented at the 2013 International Headache Conference, 178 patients were recruited for a trial. The trial compared 3 mg Melatonin, Amitryptylline (antidepressant), and placebo (no treatment). The number of headache days per month decreased by a factor of nearly three for patients taking Melatonin. The study concluded that Melatonin is effective for migraine prevention and is well tolerated by patients.

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Vitamin B12 Deficiency

Vitamin B12 deficiency may increase the risk of stroke by increasing the levels of Homocysteine. High Homocysteine level may cause early artheriosclerotic changes within vessels’ wall (hardening of vessels). By lowering Homocysteine level with vitamin B supplementation (vitamin B12 and folic acid) one may be able to reduce the risk of stroke. Blood testing may be needed to check for both Homocysteine level as well as levels of vitamin B12 and folic acid. Research data from four randomized controlled trials (included around 55 thousand participants and investigators) measured the association between B vitamin supplementation and stroke events. For this group, reduction of overall stroke events resulting from the reduction of Homocysteine levels because of vitamin B supplementation was observed.

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Approximately 50% of patients with narcolepsy remain undiagnosed. Typically, these patients complain about “being tired all the time.” You may benefit from seeing a board certified sleep specialist. Being tired of fatigued all the time may not necessarily be a sign of being “overworked” or having a depression. The reason may be narcolepsy. To identify the symptoms of narcolepsy look for five main symptoms of narcolepsy: C-H-E-S-S. Cataplexy-Hallucinations-Excessive Daytime Sleepiness-Sleep Paralysis-Sleep Disruption

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Headaches and Sleep

Clinically, patients often report that changes in sleep can bring on migraine headaches. One study found there was first human migraine gene linked to enzyme involved. Patients report that altering sleep pattern increases their migraine headaches. There is also a link between sleep pattern and the most severe vascular headaches such as cluster headaches, in which headache attacks awaken patients at night. The cluster headache demonstrates strong diurnal and seasonal periodicity with patients being awaken within a few hours of falling asleep. Observation had found that too little of too much sleep can trigger migraine headaches, and data links certain brain centers that have control of circadian and sleep mechanism with migraine pathophysiology.

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Risks of Insufficient Sleep

Lower melatonin concentrations were found in a night-shift workers, people who were exposed to artificial light at night. It was found that this increases the risk for diabetes as well. The risk increases with number of years of shift work performed. Insufficient sleep is also risk factor for weight gain and obesity.

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Melatonin and Sleep

There is some data that women with the lowest secretion of melatonin had about twice the risk of developing type 2 diabetes (after controlling for demographic lifestyle and other risk factors). It was concluded than more research is needed to elucidate final association between sleep melatonin concentration and type 2 diabetes. It is still not clear whether melatonin supplementation has a roll in treatment of metabolic syndrome.

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The sleep hormone, melatonin which is a key regulator of sleep could be also important link collecting circadian timing and insulin secretion. Melatonin production is suppressed by light and peaks around 3 to 5 hours after sleep onset. It regulates the sleep-wake cycle by lowering body temperature and causing drowsiness and promoting sleep. It was also shown that melatonin inhibits insulin secretion by pancreatic B cells. Sleep deprivation as well as age reduces melatonin production.

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Sleep and Metabolism

There is strong evidence (Lancet, June 2013) that insufficient sleep and disruption in circadian rhythm contribute to pathogenesis of metabolic disorders, cardiovascular disease, and cancer. Since world wide metabolic syndrome is on the rise, epidemiological and clinical studies have shown that short duration and poor quality of sleep may predict the development of type 2 diabetes and obesity. The study suggested that sleep abnormalities and metabolic syndrome (prodromes to diabetes) are interconnected.

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Sleep Apnea and Aging

In a recent analysis of data from epidemiological studies, investigators found that individuals with obstructive sleep apnea and disturbed sleep secondary to that had developed dementia. One hundred patients had been followed for over a decade and two multi- longitudinal studies trying to determine cardiovascular risk factors of sleep apnea. The results were adjusted for gender, age and presence of apolipoprotein E4 (gene for Alzheimer disease). The findings were presented at American Academy of Neurology Meeting. It was reported that patients who were diagnosed with OSA, had developed dementia, and that sleep apnea was independently associated with dementia diagnosis. It is not clear whether chronic sleep deprivation or lack of deep sleep versus repeated drops in oxygen level in apnea patients was the mechanism to explain the findings. They concluded that sleep disruption increases the risk of future Alzheimer’s disease. This provides an even stronger motivation to identify and treat individuals with sleep disorders such as obstructive sleep apnea.

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Headaches and Supplements

A. Headaches are complex phenomena and treatment depends on their cause or etiology. One thing that is common is that most patients respond to supplementation of magnesium, starting dose of 100 mg, increased as necessary to 200 mg. Maximum dose 500 mg per day. Mild GI symptoms with diarrhea may occur.

B. Vitamin D deficiency
Vitamin D deficiency is common in headaches patients. Blood levels of vitamin D are necessary to obtain to decide what daily dose of vitamin D one might need. Remember, Vitamin D is fat-soluble vitamin. Therefore, it needs to be taken with major meal, preferably a fat-containing meal.

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