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The hormone melatonin helps control your natural sleep-wake cycle. Natural levels of melatonin in the blood are highest at night. Some research suggests that melatonin supplements might be helpful in treating jet lag or reducing the time it takes to fall asleep — although the effect is typically mild. Melatonin might be more effective for other types of sleep issues, such as delayed sleep disorder or sleep disorders affecting circadian rhythm.

The most common melatonin side effects include:
•Daytime sleepiness
•Dizziness
•Headaches

Other, less common melatonin side effects might include abdominal discomfort, mild anxiety, irritability, confusion and short-lasting feelings of depression.

In addition, melatonin supplements can interact with various medications, including:
•Blood-thinning medications (anticoagulants)
•Medications that suppress the immune system (immunosuppressants)
•Diabetes medications
•Birth control pills

If you’re considering taking melatonin supplements, check with your doctor first — especially if you have any health conditions. The correct dose depends on the intended use. For example, circadian rhythm sleep disorders are often treated with 0.5 milligrams of melatonin a day, while doses of 3 to 5 milligrams a day might be used to treat jet lag or reduce the time it takes to fall asleep. In addition, remember that melatonin is generally recommended only for short-term use — up to two months. Some research indicates that longer term use might be appropriate in certain cases, however.

If you take melatonin, choose commercial supplements produced in a lab. Melatonin supplements made from animal sources might contain various contaminants. Don’t engage in activities that require alertness — such as driving or operating heavy machinery — for four to five hours after taking melatonin

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The amount of sleep you need depends on various factors — especially your age. Consider these general guidelines for different age groups:

Age group

Recommended amount of sleep

Infants 9-10 hours at night, plus 3 or more hours of naps
Toddlers 9-10 hours at night, plus 2-3 hours of naps
School-age children 9-11 hours
Adults 7-8 hours

In addition to age, other factors can affect how many hours of sleep you need. For example:
•Pregnancy. Changes in a woman’s body during early pregnancy can increase the need for sleep.
•Aging. Older adults need about the same amount of sleep as younger adults. As you get older, however, your sleeping patterns might change. Older adults tend to sleep more lightly and for shorter time spans than do younger adults. This might create a need for spending more time in bed to get enough sleep, or a tendency toward daytime napping.
•Previous sleep deprivation. If you’re sleep deprived, the amount of sleep you need increases.
•Sleep quality. If your sleep is frequently interrupted or cut short, you’re not getting quality sleep. The quality of your sleep is just as important as the quantity.

Although some people claim to feel rested on just a few hours of sleep a night, research shows that people who sleep so little over many nights don’t perform as well on complex mental tasks as do people who get closer to seven hours of sleep a night. Studies among adults also show that getting less or much more than seven hours of sleep a night is associated with a higher mortality rate.

If you experience frequent daytime sleepiness, even after increasing the amount of quality sleep you get, consult your doctor. He or she might be able to identify any underlying causes — and help you get a better night’s sleep

It’s unlikely you’ll become dependent on zolpidem (Ambien). Ambien and similar sleep medications are effective and much less likely to be habit-forming than are some other drugs sometimes prescribed for sleep problems — for example, benzodiazepines, such as alprazolam (Xanax), lorazepam (Ativan) or temazepam (Restoril).

However, relying on a sleep medication generally isn’t the best long-term solution for insomnia. Medications can mask an underlying problem that needs treatment. They can also cause side effects.

For example, some people who take Ambien and similar medications such as eszopiclone (Lunesta) do things while asleep that they don’t remember — such as driving, or preparing and eating food. Because you’re not awake, these are dangerous behaviors. In rare cases, these medications may trigger a life-threatening allergic reaction (anaphylaxis). Some recent studies suggest possible links between certain sleep medications and increased risk of death and cancer, but much more work needs to be done to sort out these relationships.

Sleep medications can be useful in the short term — but the best approach is to address whatever’s causing your sleep problems in the first place. If you still have trouble sleeping, other therapies include learning new sleep habits (such as keeping your bedtime and wake time consistent from day to day), getting counseling for anxiety or other psychological concerns, and using stress-reduction techniques.

If you’ve been diagnosed with Borderline Personality Disorder (BPD) or another psychiatric disorder, you’ve probably heard about Dialectical Behavior Therapy (DBT). DBT has proven successful when it comes to treating the symptoms of BPD and disorders such as anxiety, depression, substance abuse, and eating disorders.

When researching DBT treatment centers, it’s important to keep in mind that there are two methods of DBT therapy that are available to you: DBT-adherent therapy and DBT-informed therapy. The type of DBT therapy you’ll need will depend on your specific symptoms and diagnosis, so it’s a good idea to be familiar with the two options.

DBT-Adherent Therapy

Dialectical Behavior Therapy is made up of four components:
•Individual DBT therapy
•DBT skills groups
•Phone coaching with a DBT therapist
•A DBT consultation team for DBT therapists and skills trainers that meets regularly

A treatment program that is DBT-adherent will have all four of these components in place. You may be enrolled in a DBT-adherent program even if you are participating in other groups, such as relapse-prevention, 12-step, and anger management.

DBT-Informed Therapy

A treatment program that leaves out at least one of the components listed above is a DBT-informed program. For example, a DBT-informed treatment program may only offer DBT skills groups, but none of the other modes of treatment.

Which DBT Therapy Should I Choose?

Whether you end up in a DBT-adherent or DBT-informed treatment program depends on several factors:
•The severity of your disorder. If you have more severe symptoms of Borderline Personality Disorder or are behaviorally dysregulated due to emotional dysregulation, a DBT-adherent program would be more effective.
•If you have not been able to stabilize your symptoms using other therapies or treatments, a DBT-adherent program may work best for you.
•If you are seeking treatment for Borderline Personality Disorder, a DBT-adherent program may be more effective. However, if you are seeking treatment for another psychiatric disorder, such as depression or anxiety, a DBT-informed program may be appropriate.
•If you would like to retain your personal therapist and enter a DBT-adherent program, you may be referred to a DBT-informed program. Because DBT treatment is a very specific form of treatment and interventions, it can be confusing and less effective to concurrently be in another form of therapy.

Ultimately, a DBT treatment center will help you to determine whether DBT-adherent or DBT-informed treatment will work best for you.

Dialectical Behavior Therapy (DBT) teaches and reinforces four DBT skills: emotion regulation, interpersonal effectives, distress tolerance, and mindfulness. DBT skills are taught during weekly DBT skills groups and reinforced through individual DBT therapy and regular homework assignments.

There are many settings in which you can learn the four DBT skills. However, before starting your search for a DBT skills group, it is important to know if you are looking for a DBT-adherent or DBT-informed program.

DBT-Adherent vs. DBT-Informed

Dialectical Behavior Therapy is comprised of several components:
•Individual DBT therapy
•DBT skills groups
•Phone coaching with a DBT therapist
•A DBT consultation team for DBT therapists and skills trainers that meets regularly

If a DBT treatment program includes all four components, it is called a DBT-adherent program. If any of the components are not included in the treatment, it is referred to as a DBT-informed program. So, if you find the DBT program you are researching is missing, for example, individual DBT therapy or phone coaching, this is a DBT-informed program.

This can help you determine what type of DBT treatment you want. Consider your reasons and desired outcomes for participating in a DBT skills group. Determine if you are looking for treatment for your condition, if you are only curious about DBT skills, or if you just don’t feel ready for a DBT-adherent program.

If you have heard of Dialectical Behavior Therapy and you hope this might be the answer for treating your disorder, then a DBT-adherent program would be the places to inquire first. If you only want to learn skills or get a taste of what DBT could do for you, then a DBT-informed program might be a better fit.

Where to Find DBT Skills Groups

Dialectical Behavior Therapy skills groups may be offered by DBT treatment centers, community mental health programs, private mental health and counseling services, hospitals, and psychiatric disorder treatment centers.

Dialectical Behavior Therapy treatment centers are the most convenient places to find DBT skills groups because DBT is used as the primary mode of treatment for psychiatric disorders. DBT treatment centers can be residential or outpatient, and the number of DBT skills groups can vary.

Local mental health centers and hospitals may also offer DBT skills groups, depending on the location, what they treat, and what other treatments they use. Individual therapists may also run DBT skills groups as part of their private practice. Remember that if any of these places are just offering DBT skills groups and no other components of DBT treatment, they are only DBT-informed, and not DBT-adherent, programs.