DR Kristianto - Melatonin Contribution in Sleep Quality

Curicullum Vitae
Nama : Stephanus Kristianto Witono

Alamat : Jl. Pekiringan 81, Cirebon 45117
:
Pekerjaan Dokter praktek swasta Kodya Cirebon
Staf pengajar luar biasa Program Studi Pascasarjana Anti Aging &
Aesthetic Medicine Fakultas Kedokteran Universitas Padjadjaran
• Sarjana Kedokteran, Fakultas Kedokteran, Universitas Trisakti, 1988
• Disain Grafis Perwajahan, Politeknik Universitas Indonesia, 1990
• Profesi Kedokteran, CHS, Fakultas Kedokteran, Universitas Samratulangi, Manado, 1994
• Pendidikan Penaganan Penderita Gawat Darurat, PKGDI, RSCM 1994
• Advanced Trauma Life Support, PKGDI, Fakultas Kedokteran Universitas Indonesia, Jakarta, 1994
• Pelatihan Operator Tubektomi & Vasektomi, PKMI, RSUD Dr Sardjito, 1994
• Pelatihan Pelatih Operator Vasektomi, PKMI Pusat, 1995
• Advanced Cardiac Life Support Trainer, RSJN Harapan Kita, Fakultas Kedokteran Universitas Indonesia, Jakarta, 1995
• Pendidikan Penanganan Kedaruratan Jantung, RSJN Harapan Kita, Fakultas Kedokteran Universitas Indonesia, Jakarta, 1995
• Pendidikan Penanganan Pasca Bedah Terbuka Jantung, RSJN Harapan Kita, Fakultas Kedokteran Universitas Indonesia, Jakarta, 1997
• Master of Bussines Administration, Jakarta Institute of Management Studies, STIE IPWI, 1997
• Master of Science in Marketing Management, American University, Iowa, USA, 1997
• Clinical Sexology, Fakultas Kedokteran Universitas Udayana, Denpasar, 2004
• Men’s Health Intensive Course, Fakultas Kedokteran Universitas Hang Tuah & Faculty of Medicine, Vrije Universiteit, Holland, 2004
• Master of Art in Christian Theologia, Sekolah Tinggi Teologi Apostolos, Jakarta, 2006
• Advanced Clinical Sexology, Fakultas Kedokteran Universitas Udayana, Denpasar, 2008
S. Kristianto Witono
Pasca Sarjana Anti Aging & Aesthetic Medicine
Fakultas Kedokteran Universitas Padjadjaran
Sleep Deprivation Sign
Fatique
Sleep & Aging
Sleep Health Premature

Deprivation Problem Aging
Melatonin (N-acetyl-5-methoxy tryptamine)
 Melatonin is a neuro-hormone made from the amino acid tryptophan
 Produced predominantly in the brain’s rice-grain-sized pineal gland
 Regulates the internal body clock’s cycle of sleep and wakefulness.
 Produce more in dark ambience and less in light ambience
 Melatonin was first isolated from the bovine pineal gland in 1958.
Sleepdex. Retrieved 17 August 2011

Lerner AB, Case JD, Takakashi Y, et al. Isolation of melatonin, the pineal gland factor that lightens melanocytes. J Am Chem Soc. 1958;80:2587
Hardeland R, Pandi-Perumal SR, Cardinali DP (March 2006). "Melatonin". The International Journal of Biochemistry & Cell Biology. 38 (3): 313–6
Altun A, Ugur-Altun B (May 2007). "Melatonin: therapeutic and clinical utilization". Int. J. Clin. Pract. 61 (5): 835–45
Melatonin Synthesis
http://www.vox.com/2014/11/21/7255227/seasonal-affective-disorder
 Melatonin is involved in the entrainment (synchronization) of the
circadian rhythms including sleep-wake timing, blood pressure
regulation, seasonal reproduction, and many others
 Other claims are made for it: it has anti-oxidant, free radical
scavenging properties. Some say it has anti-cancer and anti-ageing
effects, but there is no proof for this in humans.
Sleepdex. Retrieved 17 August 2011

Lerner AB, Case JD, Takakashi Y, et al. Isolation of melatonin, the pineal gland factor that lightens melanocytes. J Am Chem Soc. 1958;80:2587
Hardeland R, Pandi-Perumal SR, Cardinali DP (March 2006). "Melatonin". The International Journal of Biochemistry & Cell Biology. 38 (3): 313–6
Altun A, Ugur-Altun B (May 2007). "Melatonin: therapeutic and clinical utilization". Int. J. Clin. Pract. 61 (5): 835–45
Human Biological Clock
http://www.thepaleomom.com/wp-content/uploads/2015/08/biological_clock.png
Melatonin Fluctuation
Forster P. Melatonin & Sleep. https://www.gatewaypsychiatric.com/melatonin-and-sleep/

Melatonin & Ageing
English J. Restoring Deep, Slow Wave Sleep to Enhance Health and Increase Lifespan.
https://nutritionreview.org/2014/07/restoring-slow-wave-sleep-shown-enhance-health-increase-lifespan/
Melatonin & Ageing
http://jpp.krakow.pl/journal/archive/08_08_s1/gfx/rys0401.gif
Technology impact Melatonin Production
What is Sleep
 Human life is divided into sleep and wake states.
 Sleep is a state where the brain controls various physiological functions
of the body to prepare such as alertness, memory, reasoning, learning,
reflexes, motor skills and a general sense of well-being.
 During sleep important substances in the brain and nervous system are
replenished and byproducts.
 Adequacy or quality of sleep has a significant impact on other aspects
of human health, including risk of heart attack and stroke,
hypertension, diabetes prevention & control, weight control & aging
process.
https://www.getsleepnj.com/sleep
Insufficient Sleep can Make You
Sleep can Make You
http://www.activevegetarian.com/wp-content/uploads/2016/02/Sleep-Chart.png
Melatonin Clinical Indication
INDICATION EVIDENCE INDICATION EVIDENCE
Delayed sleep phase syndrome (DSPS) B High blood pressure C

Insomnia High cholesterol C
B
HIV/AIDS C
Jetlag B
Memory C
Behavioral, developmental & mental disorders B
Menopause C
Sleep enhancement in healthy people B
Pain C
Age-related macular degeneration C
Parkinson's disease C
Aging (body temperature regulation) C
Periodic limb movement disorder C
Alzheimer's disease/ cognitive decline C REM sleep behavior disorder C
Anti-inflammatory C Restless leg syndrome C
Benzodiazepine withdrawal C Rett's syndrome C
Cancer treatment C Tinnitus C
Chronic fatigue syndrome C Sarcoidosis C
Chronic obstructive pulmonary disease C Schizophrenia C
Circadian rhythm sleep disorders C Seasonal affective disorder (SAD) C
Delirium C Seizure disorder C
Depression C Skin sun damage C
Diabetes (additional therapy + Zn) C Smoking C
Exercise performance Stomach disorders (and intestine disorders) C
C
Stroke C
Fertility C
Surgery C
Fibromyalgia C
Tardive dyskinesia C
Glaucoma C
Thrombocytopenia (low platelets) C
Headache C
Ulcers C
Heart disease C
Urination (waking up at night to urinate) C
Doses
Melatonin is taken in doses from 0.2 mg to 20.0 mg, based on the reason
for its use. The right dose varies widely from one person to another.
Innominato PF, Lim AS, Palesh O, Clemons M, Trudeau M, Eisen A, etal. The effect of melatonin on sleep and quality of life in patients
with advanced breast cancer. Support Care Cancer. 2016 Mar; 24(3): 1097-105.
Herxheimer, A., Petrie, K.J. Melatonin for the prevention and treatment of jet lag. Cochrane Database System Review, 2002. (2): CD001520.
Melatonin Side Effect
 Sleepiness or daytime sleepiness
 Headaches / dizziness
 Lower body temperature
 Vivid dreams
 Morning grogginess
 Small changes in blood pressure

Melatonin Interaction w/
 Blood-thinning medications (anticoagulants)
 Medications that suppress the immune system (immunosuppressants)
 Diabetes medications
 Birth control pills
Melatonin Precursor
http://www.vivo.colostate.edu/hbooks/pathphys/endocrine/otherendo/pineal.html
Melatonin Synthesis
https://understand-andcure-anxietyattacks-panicattacks-depression.com/images/5-htp-Serotonin.jpg
Melatonin Synthesis
http://www.chemicalbiological.net/catecholamine%20pathway_sertonin_melantonin.jpg
Tryptophan Rich Food
http://www.healthline.com/health/healthy-sleep/foods-that-could-boost-your-serotonin?m=2#food-and-mood9
Food that Help You Sleep
Other way to Boost Melatonin
 Exercise
 Sunshine
 Positivity
https://www.getsleepnj.com/sleep
Conclusion
 As a human being we need to sleep to promote health hormonal system
which is essential to regenerative our body cells
 Due to normal sleep pattern we need normal melatonin level in its

circadian rhythm.
 As we going old, our melatonin level decrease below normal level, we

can induce more melatonin production by good healthy life or
subtitued melatonin with the right dose
Terimakasih
Program Studi Pasca Sarjana Anti Aging & Aesthetic Medicine

Fakultas Kedokteran Universitas Padjadjaran

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Curicullum Vitae

Nama : Stephanus Kristianto Witono

Sleep Health Premature

 Produced predominantly in the brain’s rice-grain-sized pineal gland

 Regulates the internal body clock’s cycle of sleep and wakefulness.

 Produce more in dark ambience and less in light ambience

Sleepdex. Retrieved 17 August 2011

Sleepdex. Retrieved 17 August 2011

Forster P. Melatonin & Sleep. https://www.gatewaypsychiatric.com/melatonin-and-sleep/

Delayed sleep phase syndrome (DSPS) B High blood pressure C

 Lower body temperature

 Small changes in blood pressure

 Medications that suppress the immune system (immunosuppressants)

 Birth control pills

 Due to normal sleep pattern we need normal melatonin level in its

 As we going old, our melatonin level decrease below normal level, we

Program Studi Pasca Sarjana Anti Aging & Aesthetic Medicine

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