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Changes in daylight and temperature can disrupt sleep patterns
Melatonin has limited evidence supporting its use for general insomnia
Loud snoring and frequent nighttime awakenings may signal sleep apnea

As autumn settles in, some people find themselves struggling to get a good night's sleep. They may lie awake for hours before falling asleep or wake up in the early morning and have difficulty drifting off again. Although these problems may seem temporary, recurring sleep difficulties warrant a closer look at sleep patterns and overall health.

During autumn, shorter daylight hours and changing temperatures can affect sleep. In particular, changes in morning sunlight exposure may disrupt the body's internal clock, which regulates the sleep-wake cycle.

However, reaching for melatonin whenever sleep becomes difficult may not be the best approach. Insomnia can have many different causes, and relying solely on melatonin may delay the diagnosis of an underlying sleep disorder that requires treatment.

Melatonin Doesn't Work for Every Type of Insomnia

Melatonin is a hormone produced by the brain that helps regulate the sleep-wake cycle. Its production generally increases in darkness and decreases when the body is exposed to morning light. This is why many people assume that taking melatonin will help them fall asleep. However, it is not effective for every type of insomnia.

In its 2017 clinical practice guidelines, the American Academy of Sleep Medicine (AASM) recommended against using melatonin to treat sleep-onset and sleep-maintenance insomnia in adults. The recommendation was based on insufficient evidence supporting its effectiveness for these conditions.

Sleep-onset insomnia refers to difficulty falling asleep at bedtime, while sleep-maintenance insomnia involves waking up repeatedly during the night or having trouble falling back asleep.

However, prolonged-release melatonin formulations may be considered for certain older adults. These formulations release the active ingredient gradually over time. Whether they are appropriate depends on the patient's age, symptoms, and a healthcare professional's assessment.

Products marketed as "plant-based melatonin" have also become increasingly visible. However, consumers should distinguish between prescription melatonin medications and products sold as conventional foods or dietary products. Products classified as foods have not been approved as insomnia treatments on the same basis as prescription medications. Nor does a plant-derived label automatically guarantee effectiveness or safety.

Jin-kyu Han, director of the Seoul Sleep Center, cautioned that plant-based melatonin products currently available in South Korea generally contain small amounts of melatonin within plant extracts, and the sleep-related effects of the plant extracts themselves have not been adequately evaluated.

He emphasized that relying solely on melatonin without identifying the underlying cause of insomnia may allow an underlying condition to go undiagnosed and potentially worsen. Finding out why someone is having trouble sleeping, he said, should be the first priority.

Snoring and Insomnia Together May Point to Sleep Apnea

When insomnia persists, it is important to determine whether the problem is simply insufficient sleep or whether another sleep disorder may be involved.

People who snore loudly and frequently wake up during the night—or wake in the early morning and cannot fall back asleep—should consider the possibility of obstructive sleep apnea (OSA).

OSA is a condition in which the upper airway repeatedly narrows or becomes blocked during sleep, causing breathing to stop or become reduced. These breathing disturbances can trigger repeated awakenings in the brain, leaving people feeling tired and sleepy during the day even when they believe they have slept long enough.

When insomnia and obstructive sleep apnea occur together, the condition is known as comorbid insomnia and sleep apnea (COMISA). Because the two disorders can produce overlapping symptoms, patients may attribute their frequent awakenings solely to insomnia, delaying the diagnosis of sleep apnea.

Han explained that when insomnia and sleep apnea occur together, treatment may require a combination of breathing therapy and cognitive behavioral therapy rather than medication alone.

If sleep apnea is suspected, a sleep study, known as polysomnography, may help identify the underlying problem. This test measures several physiological signals during sleep, including brain activity, breathing, and blood oxygen levels, to provide a comprehensive assessment of sleep.

The need for testing is determined through a medical evaluation. Insurance coverage may also vary depending on the suspected condition and applicable coverage criteria.

Keep a Consistent Wake-Up Time and Get Morning Sunlight

Maintaining a regular sleep schedule is important for reducing sleep difficulties during seasonal transitions.

Even after a poor night's sleep, try to wake up at approximately the same time every day. An irregular wake-up schedule can further disrupt the body's natural sleep-wake rhythm.

Getting adequate sunlight in the morning can also help. Light is one of the body's most important signals for regulating its internal clock, and consistent morning light exposure can help maintain a healthy sleep schedule.

Before bedtime, develop a routine that helps relax both the body and mind. Soaking your feet in warm water one to two hours before bed may be worth trying, but avoid water that is excessively hot.

Most importantly, persistent insomnia that does not improve with lifestyle changes should be evaluated to determine its underlying cause.

Han recommends seeking medical advice if sleep difficulties persist for about two weeks and are accompanied by daytime fatigue or difficulty concentrating, rather than waiting for the symptoms to become more prolonged.

People who experience severe snoring or episodes of stopped breathing during sleep should not dismiss these symptoms as ordinary insomnia. A professional evaluation may be necessary to determine whether a sleep disorder is responsible.

Source: 헬스경향 (https://www.k-health.com/news/articleView.html?idxno=101945)