“Most work to earn money, and often, instead of eight hours, their shifts last 12”
Pharmaceutical market analysts note an increasing increase in sales of drugs for insomnia — primarily over-the-counter, based sleep hormone melatonin. The growth began with the start of the pandemic – and continues to this day. According to the SRO «Association of Independent Pharmacies», over the past five years, sales of drugs with a hypnotic effect in packages have increased approximately one and a half times.
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According to the analytical company DSM Group, sales of products from the category “hypnotics and sedatives” in 2022 grew by 14% compared to last year, and in 2023 by another 9% in rubles, and products containing melatonin grew the most (24 and 11%, respectively). In addition, sales of melatonin products in packages also increased (by 25% in 2022 and by 10% in 2023).
There are several explanations for this. The number of sleep disorders and depressive disorders began to rise sharply amid the pandemic, and after February 2022 this trend only intensified. Unfortunately, not everyone goes to the doctor with such problems – so they run to the pharmacy for something sedative or sleeping pills. "Patients can’t always get an appointment with a doctor and get a prescription, so they come to the pharmacy and ask for an over-the-counter drug or dietary supplement to improve sleep quality," says the director of the SRO «Association of Independent Pharmacies», head of the Alliance of Pharmaceutical Associations Victoria Presnyakova. – However, in recent years, the distribution of sleeping pills has become more stringent. Some of them were transferred to the group of potent drugs; Some are dispensed with a regular prescription, but it must remain in the pharmacy and be stored for 3 months. There are also drugs for which prescriptions are not withdrawn, but nevertheless they are prescription drugs. And melatonin, produced under different trade names, is not prescription. Therefore, first of all, various products based on it are bought up, some of them are not registered as medicines.”
Recently, analysts point to a record increase in sales of melatonin for 2023 compared to the previous 5 years, and in rubles and packages. Let's figure out what this might be connected with.
Melatonin – a hormone that regulates the sleep-wake cycle in humans and animals. Its normal content in the body is necessary to maintain health and normal functioning of the nervous system. It is produced by the pineal gland. Research shows melatonin has more to do with more than just sleep. The sleep hormone reduces the production of cytokines that cause inflammation, is an antioxidant that neutralizes free radicals in cells, and limits oxidative stress and damage that contribute to inflammation. Melatonin is produced in the brain when light stops falling on the retina of the eye. Therefore, using gadgets at night disrupts the production of natural melatonin in the body. This causes problems in falling asleep. Increased anxiety also contributes to a decrease in the production of the sleep hormone. “Unfortunately, recently, due to the increase in the use of gadgets, as well as the increase in the level of anxiety in society,” the number of calls to the pharmacy for melatonin-containing drugs has sharply increased, – says Victoria Lesnikova, director of the Association of New Independent Pharmacies. – Neurologists and psychiatrists note an increase in the number of patients, especially among young people. However, there are many myths and stereotypes in society that cause resistance to seeking help from a doctor. Recently, various melatonin-based preparations have been actively advertised in the media. And due to the fact that many drugs with a hypnotic effect familiar to our patients have become prescription drugs, the demand for more affordable analogues has increased. Including often dubious dietary supplements, widely represented on marketplaces where there is no strict quality and safety control, as in pharmacies.»
The director of a pharmacy chain from the Tver region, Tatyana Semenova, notes that surges in demand are observed after advertising campaigns on television, but in general the demand for this type of product is steadily growing. "For example, compared to the previous year in 2023, sales through our network increased by 26.5%. The reasons for the increase in insomnia and anxiety are also clear to everyone. These are gadgets and a difficult economic situation. Today, most people work to earn money, and often instead of eight hours, their shifts last 12 hours, which leads to disruptions in the body's circadian rhythms. We believe that “we’ll get some sleep in the next world.”… You know, I noticed that young people have recently – on antidepressants and sleeping pills. And many are already coming with prescriptions from psychotherapists.”
In the meantime, psychiatrists and somnologists do not recommend self-medication and “throwing away” drugs that people «prescribe» themselves, including seeing advertising on TV.
The most common cause of insomnia is chronic stress. As psychiatrist and somnologist Oksana Sadykova says, "sleep– genetically determined state of all warm-blooded animals; against the background of insomnia, disturbances in the functioning of all organs and systems begin. For example, experiments with two groups of dogs showed that in the group where the animals were not allowed to sleep, within two weeks their hair began to come out, their fangs began to fall out… Even a slight lack of sleep leads to an increase in C-reactive protein – markers of inflammatory processes, cytokines and tau proteins (which, according to various theories, provoke the development of Alzheimer's and Parkinson's diseases). Sleep is needed to consolidate memory and process emotions. And in the slow-wave sleep phase, a deep scan of the entire body occurs. There is a visceral theory of sleep: during sleep, the brain completely scans the body and cleanses it of tau protein and beta-amyloid. Sleep – like a washing machine, and if a person does not sleep, nothing is washed. Well, immunity is also restored in sleep.
If we talk about melatonin, it turns on sleep centers and helps you fall asleep. Its production begins in the evening, at 19-20 o'clock, and the peak occurs at 1-2 o'clock in the morning. And if its first catalyst is light, then the second is – intestinal microbiota, which helps convert tryptophan into melatonin. Recently, melatonin was discovered, which is synthesized in the intestines (mostly in the appendix, so those who have it cut out lose such richness). As part of the intestinal microbiota – more than a thousand bacteria that synthesize tryptophan, dopamine and melatonin and interact with the central nervous system.
However, I do not recommend additional intake of melatonin for the treatment of insomnia in the form of various drugs. The gold standard for treating insomnia – cognitive behavioral therapy. It is necessary to ensure that melatonin is synthesized by the intestines – that is, consume fiber, and in the evening. The light regime is also very important: it should be dark at night, in the evening – warm yellow light, and in the morning – white cold. Your sleep schedule is also important: if you are used to going to bed at two in the morning and have been living like this for ten years, you don’t need to change anything. The amount of melatonin depends on your lifestyle and age, its production adapts to you.
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