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Columnist
Explore options for better, longer sleep
By Dr. Ed Blonz | Daily Herald Columnist
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Published: 11/24/2008 1:45 AM

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Q. Can you please give me some information on the dietary supplement melatonin, which is supposed to be associated with sleep/wake patterns? Is it supposed to be a sleep aid?

M.H., via e-mail

A. Melatonin, a hormone produced by the pea-sized pineal gland that is located in the center of the brain, is thought to be a key player in the control of the body's sleep/wake rhythms.

The release of melatonin is stimulated by darkness and inhibited by light. The rationale behind taking melatonin supplements for a sleep disorder, such as jet lag, is that it will cajole the body into a more rapid shift to the new time zone. There is some research to support this, but it is inconsistent at best. A meta analysis in the Feb. 18, 2006 issue of the British Medical Journal reported that melatonin does not seem to be very effective for sleep disorders.

For most, there is little danger in trying melatonin, as most studies note an absence of adverse effects - especially when small dosages (3 milligrams per day) and short-term use is involved. There is a good review of melatonin at the Memorial Sloan Kettering Web site at tinyurl.com/3njx9f.

As for other sleep aids, a warm glass of milk (flavored or not) before bedtime, and/or a warm bath, are tried-and-true remedies. Tryptophan is an amino acid that serves as the precursor to a key brain chemical (neurotransmitter) called serotonin, which encourages relaxation. A metabolite of tryptophan, called 5-HTP, is also available, but again, I would not recommend using this product on a regular basis. Valerian is an herb that is also used to treat insomnia.

Whatever you decide, be upfront with your physician to alert him or her to your sleep issues and avoid potential interactions between your sleep aid and any medications or health conditions.

Other approaches to consider: A good diet and regular exercise habits help with sleep. They not only help to decrease stress, which is a potent sleep robber, but exercise can help tweak the body toward a regular activity/regeneration cycle. There are a number of relaxation techniques and tapes that may be of help.

Q. This question concerns a practical diet for a renal-failure patient: Is there any way foods high in potassium (almost everything) and phosphorus can be "neutralized," for the lack of a better word, so they are safer for the patient to eat? I have a brother on dialysis, and he seems to be slowly starving to death. He can't eat enough of the low-potassium food to get enough calories to maintain his weight. Any recommendations?

J.S., San Diego, Calif.

A. You need to speak with a dietitian who specializes in renal-failure patients. There isn't a way to neutralize the nutrients. The kidneys pull excess amounts out of the body, and, if they are not working, the levels will rise. Those in renal failure often rely on a dialysis machine to "cleanse" the blood and help bring levels within normal limits.

Please find a good dietitian. He or she may recommend some special nutrient-rich drinks specially made for renal patients. You will find additional information at tinyurl.com/4ucfua. I wish you and your brother well.

• Ed Blonz, Ph.D., is a nutrition scientist and the author. Write him at "On Nutrition," Ed Blonz, c/o Newspaper Enterprise Association, 200 Madison Ave., New York, NY 10016 or ed@blonz.com. Due to the volume of mail, personal replies cannot be provided.