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Advancing Care - April 2022

man, sleeping, alarm

 

Melatonin: Does it really help you sleep? 

It’s 2 am and you can’t sleep. The alarm clock is set to go off in just a few hours. Is it time to reach into the medicine cabinet?

In a January 2022 survey (Casper-Gallup State of Sleep in America 2022 Report), more than half of American adults reported using some kind of sleep aid for insomnia; 11 percent turned to nonmedicinal, over-the-counter products such as melatonin. Sold as a supplement, melatonin is a hormone that influences sleep. It helps to regulate the timing of your overall sleep-wake cycle and set your circadian clock, the internal timekeeper that tells your body what time of day it is. Depending on when melatonin is taken, small amounts can alter the timing of your internal clock.

According to Brittany Langdon, PharmD, manager of the Apothecary and Wellness Center at Yale New Haven Hospital, people should consult their doctor or a sleep specialist before taking melatonin because the supplement does not address any underlying health problems that may be disrupting sleep. Many treatable medical issues – such as anxiety, sleep apnea, restless legs syndrome or mood disorders like depression — can cause insomnia. 

Many people believe taking melatonin will help them fall asleep faster. While some melatonin research suggests that melatonin may slightly reduce the time it takes certain people to fall asleep, taking it incorrectly may actually aggravate – rather than help – sleep issues. 

Think proper dosage and timing when it comes to melatonin. Make sure you’re taking it at the same time every day – because if you take it at different times during the day, you can confuse your circadian clock. 

Should you decide to give melatonin a try for your sleepless nights, remember there’s no guarantee it will work for you, Langdon noted. “Melatonin affects people differently. Some may have great results using it, others may not benefit at all,” she said. 

What dosage is recommended for people who are having problems sleeping? “For insomnia, we typically suggest doses of 3 - 5 mg in the evening about one hour before bed. In elderly patients we recommend a reduced dose of 1- 2 mg to limit confusion or disorientation,” Langdon said. 

The most common side effects include headache, dizziness, nausea and drowsiness. On rare occasions, Langdon said melatonin can cause some feelings of depression, confusion or irritability. 

Melatonin can interact with and affect other medications you may be taking. “Some common ones are anticoagulants, antiplatelets, contraceptives, diabetic meds and immunosuppressants,” she said. “We suggest avoiding melatonin all together in patients who are diagnosed with autoimmune diseases – and, of course, we always recommend consulting with your doctor or pharmacist before taking any vitamin or supplement.” 

So why do some people swear by it? According to Langdon, melatonin may benefit from the “placebo effect” – if people believe that it works, then they will start to relax and fall asleep. “Some studies have suggested that melatonin can improve both the time to fall asleep and total sleep. Other studies show a placebo being equally as effective,” she said. “In the end, melatonin may be modestly effective for short periods, but people with long-term sleep problems should consult their doctor to find a more reliable solution.”

Ten tips for a good night’s sleep

Having trouble falling asleep? Here are 10 tips from YNHH’s Sleep Medicine Program that may help you relax. 

  • Make sleep a priority. Try for 7 - 9 hours of sleep each night. Children should get between 9 and 12 hours. 
  • Get up at the same time each morning to help set your biological clock.
  • Maintain a healthy diet. Your weight, blood pressure and cholesterol can cause health problems associated with poor sleep. Finish eating meals 2 - 3 hours before bedtime. 
  • Get regular exercise. It helps you fall asleep quicker and promotes deeper sleep. Avoid heavy exercise 2 hours before bedtime.
  • Minimize napping. If you need to stay alert, take a 20 - 30 minute “power nap” before late afternoon.
  • Avoid caffeinated beverages and minimize alcohol and smoking, especially in the evening. 
  • Develop a bedtime routine to help you relax:
    • Make a “worry list” of your concerns and put it aside. This helps stop you from taking problems to bed.
    • Try muscle relaxation exercise, deep breathing, yoga or meditation.
    • Avoid drinking a lot of liquids in the evening so your sleep isn’t interrupted later by trips to the bathroom
    • Take a hot bath an hour or two before bedtime.
  • Create an optimal sleep environment:
    • Avoid watching TV or using your phone or computer while in bed.
    • Keep the room temperature moderate.
    • Keep the room dark for sleeping – use light-blocking curtains if needed.
    • Turn the clock away from the bed or cover it up.
    • Use a sound machine to block out sounds that may disturb you.
    • Don’t sleep with your pets. They can disrupt your slumber.
  • If you are still awake after 15 - 20 minutes, get up and do another quiet activity. 
  • Talk to your doctor. Uncontrolled anxiety worsens during sleep and certain drugs or supplements may also affect your sleep.  If you have an urge to move your legs at night, you may have restless leg disorder (RLS), which is treatable. 

YNHH’s Sleep Medicine program offers diagnostic testing and treatment if you are unable to get a restful night sleep. Physicians are board-certified in sleep medicine, internal medicine, pulmonary disease, neurology, psychology and pediatrics. For more information, call 203-287-3550.

YM-YNHH wayfinding app gets you where you need to go 

You arrive for your medical appointment and park in a garage. But how do you find your way to the office? At Yale New Haven Health, there’s an app for that. 

Trying to navigate a healthcare facility with multiple buildings and offices can be overwhelming. With YM-YNH Go, you can find the care you need, when and where you need it. The free wayfinding app provides a map of the hospital to your smartphone and allows you to navigate in real time. 

Download YM-YNH Go before your next appointment to:

  • Get turn-by-turn directions from your home to dozens of Yale New Haven Health locations, including hospitals, walk-ins, emergency departments and outpatient locations
  • Drop a reminder pin at your parking space
  • Find amenities inside hospitals and ambulatory locations like dining, restrooms and ATMs
  • Search for a doctor near you
  • Find the nearest emergency departments and urgent care centers
  • Connect with your Yale New Haven Health MyChart account for video visits, online bill pay and more

The app is also available for download from Apple or Google Play

Save a life: Be a living organ donor

Would you be surprised to learn that more than 100,000 people in the United States are waiting for a lifesaving organ transplant? It’s true. In fact, 17 people die every day while waiting for a transplant, and another person is added to the nation’s organ transplant wait list every nine minutes.

It’s also true that 85 percent of patients on the list are waiting for a kidney. Another 11 percent are waiting for a liver. The need for organs is far greater than their availability. Living organ donation and transplantation was developed due to a critical shortage of deceased donors. According to Donate Life America, 5,700 people received an organ from a living donor in 2020. For many of these patients, a transplant from a living donor leads to better outcomes. Those who receive a living donor transplant are removed from the national transplant waiting list – which makes the gift of a kidney or liver from a deceased donor available for someone else in need.

The Center for Living Organ Donors at Yale New Haven Hospital is a program that arranges for kidney and liver transplants from living donors. If you or a loved one are interested in learning more about becoming a liver or kidney donor, contact the YNHH Transplantation Center at 866-925-3897. 

Spring cleaning your medicine cabinet

If your medicine cabinet is chock-full of expired or unneeded medications, what’s the best way to throw them out properly without endangering your family or harming the environment? 

The first step is to follow any disposal instructions that came with your meds. If there are no disposal instructions, dispose of drugs in your household trash by doing the following:

  • Keep the medication in its original container. Remove the label or use a permanent marker or duct tape to cross out your personal information.
  • Make medication less appealing to pets or children. Mix your drugs (liquid or pills) with hot water to dissolve them. Increase the yuckiness factor by adding salt, ashes, saw dust, used coffee grounds or kitty litter.
  • Contain and seal. Place it inside a container such as an empty yogurt or margarine tub to ensure that the contents cannot be seen and tape it shut.
  • Throw out the container in your trash can. Do not put the container in your recycling bin! Don't flush medication down the sink or toilet. Why? Because flushed medications can get into our lakes, rivers and streams. 

April 30 Is National Prescription Drug Take Back Day, which aims to provide a safe, convenient and responsible means of disposing of prescription drugs. Locate a collection site near you.  

MyChart: Your medical information in one place

MyChart gives Yale New Haven Health patients secure, online, 24/7 access to portions of your electronic medical record (EMR). There, you can see your medical history, most laboratory and test results, appointment information, medications, allergies, immunizations and other health information. You can schedule appointments with your doctor, request or renew prescriptions, pay your bill, and send and receive secure, confidential electronic messages with your doctor’s office. Sign up by using the activation code on the after-visit summary from your doctor, request a MyChart Activation Code at your next appointment or visit MyChart and select “Sign Up Now.”

Find a Doc at YNHH

Are you looking for a physician? Call 888-700-6543 or visit our website’s Find a Doctor feature for information on physician specialties, office hours and locations as well as insurance plans accepted. Many of our physician practices offer telehealth video visits for your convenience. 

Billing questions?

Yale New Haven Hospital offers financial counseling to patients and families. Spanish-speaking counselors are also available. To make an appointment with a financial counselor, call 855-547-4584.