No problem.
----- Original Message ----- 
From: "Todd Struve" <[log in to unmask]>
To: <[log in to unmask]>
Sent: Friday, November 10, 2006 5:52 PM
Subject: Re: Anybody awake out there in computer land


> Lyn, that sure is an interesting article.  Thanksfor
> sharing.
> Todd
> --- Lyn Latham <[log in to unmask]> wrote:
>
>> Oh man!  This sleep thing is really horrible.  So, I
>> have something that
>> might help us all.  Although I have tried this
>> medicine and it didn't work.
>> Do you guys know about this?  They are stating in
>> this article that
>> sometimes it works if you take it and then stop.
>> Here I have copy pasted it
>> for you all.  I try not to send attachments or
>> forwards.  Try this out.
>> Psychiatr News September 1, 2006
>> Volume 41, Number 17, page 26
>> © 2006
>> American Psychiatric Association
>> Clinical & Research News
>> Melatonin Effective In Totally Blind People
>> Lynne Lamberg
>> Melatonin corrects circadian-rhythm disturbances
>> that often lead to severe
>> and persistent insomnia in individuals who are
>> totally blind.
>> Totally blind people-those who cannot perceive
>> light-often report difficulty
>> falling asleep and staying asleep, as well as
>> fatigue, poor concentration,
>> and irritability while awake.
>> More than half of these individuals, an estimated
>> 50,000 to 100,000 people
>> in the United States alone, may have a potentially
>> correctable
>> circadian-rhythm
>> sleep disorder, sleep specialists say.
>> Exogenous melatonin is the treatment of choice for
>> blind people with
>> non-24-hour sleep-wake disorder," said robert Sack,
>> M.D., a professor of
>> psychiatry
>> at Oregon Health and Science University (OHSU) in
>> Portland.
>> Sack chaired a symposium on using melatonin in the
>> blind at the annual
>> meeting of the associated Professional Sleep
>> Societies (APSS) in Salt Lake
>> City,
>> Utah, in June. He and other speakers recently
>> discussed their research with
>> Psychiatric News.
>> The high prevalence of sleep problems in the blind
>> underscores the
>> importance of light in regulating circadian rhythms
>> in the sighted, Sack
>> said. In sighted
>> people, sunlight signals travel from the eyes to the
>> body's master
>> biological clock in the hypothalamus over a pathway
>> distinct from that for
>> vision. Shifting
>> levels of light across the day entrain, or
>> synchronize, the sleep-wake
>> cycle, endogenous melatonin release, and other
>> biological rhythms with the
>> earth's
>> day/night cycle.
>> Most people, sighted and blind, have innate daily
>> cycles of 24-25 hours,
>> noted Alfred Lewy, M.D., professor and senior vice
>> chair of psychiatry at
>> OHSU.
>> In sighted people, daily exposure to sunlight
>> automatically resets cycle
>> length to the world's 24-hour day. More than half of
>> totally blind people
>> have
>> a 24.5-hour circadian cycle, Lewy said. They
>> commonly drift later and later
>> around the real time clock, a phenomenon known as
>> "free-running."
>> Even if they try to sleep at regular times, they
>> typically sleep well only a
>> few days a month, when their internal clocks fall in
>> sync with preferred
>> schedules.
>> At other times, they sleep poorly and feel drowsy
>> while awake. Some
>> experience depressive symptoms.
>> Daily oral doses of melatonin can entrain these
>> blind free-runners,
>> researchers at the University of Surrey in the
>> United Kingdom reported in
>> January 2000
>> in the Journal of Endocrinology.
>> Lewy's group suggests doses of about 0.02-0.3
>> mg/day, approximating
>> physiological secretion, usually taken in the late
>> afternoon or early
>> evening, may
>> be
>> most effective. They published a dose-response curve
>> for use of exogenous
>> melatonin in the physiological range in totally
>> blind people in
>> Chronobiology
>> International in December 2005.
>> Jonathan Emens, M.D., an assistant professor of
>> psychiatry at OHSU, working
>> with Lewy and others, reported at the APSS meeting
>> that his group had shown
>> for the first time that exogenous melatonin also can
>> entrain blind
>> free-runners with periods less than 24 hours. The
>> researchers helped a blind
>> 41-year-old
>> woman and a blind 9-year-old girl stop drifting
>> earlier around the clock.
>> (The long-term safety of giving melatonin to
>> prepubertal children has not
>> been
>> established.)
>> Melatonin also may help blind people with 24-hour
>> rhythms that persistently
>> run early or late, disrupting work and social life,
>> Emens said. Melatonin
>> shifts
>> biological rhythms earlier or later depending on
>> when it is taken.
>> Findings from research in the blind, he suggested,
>> may be applicable to
>> shift work, jet travel, and other circadian sleep
>> disorders.
>> Figure 1
>> ©
>> iStockphoto.com/hidesy
>> Determining the optimal dose and timing of melatonin
>> administration for the
>> individual user is a key focus of ongoing research,
>> said Debra Skene, Ph.D.,
>> a professor of neuroendocrinology at the School of
>> Biomedical and Molecular
>> Sciences, University of Surrey in Guildford, Surrey,
>> United Kingdom. An
>> individual's
>> response to melatonin depends on both clock time and
>> circadian time, she
>> said, and on how long the person takes it.
>> Individual circadian cycle length also may affect
>> treatment outcome, Skene
>> said. People with an innate period longer than 24.5
>> hours seem to have more
>> trouble
>> entraining than those with shorter cycles. Different
>> formulations of
>> melatonin, including fast release, sustained
>> release, and controlled
>> release, may
>> have different effects.
>> Before treatment starts, every patient needs a
>> correct diagnosis, said
>> Steven Lockley, Ph.D., an assistant professor of
>> medicine at Harvard Medical
>> School.
>> "I know of blind people with non-24-hour sleep-wake
>> disorder who have been
>> given hypnotics to use at night and stimulants to
>> use in the day because
>> their
>> physicians did not recognize the cyclic nature of
>> their disorder," he said.
>> An estimated 1 in 4 totally blind people can entrain
>> to 24-hour rhythms
>> using nonphotic time cues in their environment,
>> Lockley noted. These cues
>> include
>> regular times for sleep, meals, exercise, work,
>> social relationships,
>> caffeine, and medications. Some blind people with no
>> conscious light
>> perception still
>> may have light-sensitive cells in the retina that
>> enable entrainment.
>> Blind people able to perceive any light are unlikely
>> to have a circadian
>> rhythm sleep disorder, he said. However, visually
>> impaired people overall
>> have
>> higher rates of sleep disorders than people with
>> normal vision.
>> Asking a patient to keep a sleep diary or wear a
>> wrist activity monitor for
>> at least two months probably will reveal a cyclic
>> sleep-wake disorder if one
>> exists, he said. Collection of urine samples every
>> four to eight hours for
>> 48 hours every two weeks for two months to assess
>> melatonin or cortisol
>> rhythms
>> can help make a definitive diagnosis and aid a
>> decision about appropriate
>> treatment timing. These noninvasive, relatively
>> inexpensive measures, he
>> said,
>> are practical in primary care practice.
>>
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