A Systematic Review of the Effectiveness of Oral Melatonin for Adults (18 to 65 Years) with Delayed Sleep Phase Syndrome and Adults (18 to 65 Years) with Primary Insomnia

Abstract

Oral melatonin supplementation has been heralded as a treatment for the sleep disorders of delayed sleep phase syndrome (DSPS) and primary insomnia (PI) in adults (18 to 65 years). However, there is inconsistency in the literature and many of the claims for melatonin appear to be based upon its effect in older adults (> 65 years). This article reviews, systematically, studies of oral melatonin in adults (18 to 65 years) with either delayed sleep phase syndrome (DSPS) or primary insomnia (PI).Following electronic database searching, and hand-searching of relevant journal titles, fourteen articles that examined the use of melatonin in adults with PI or DSPS were identified for inclusion in this review (eight for DSPS and four for PI). Generally, the quality of articles is limited, particularly with regard to reporting of sleep parameters. However, results indicate that melatonin may phase-advance the sleep of individuals diagnosed with DSPS, although the majority of this evidence comes from uncontrolled trials. There is little evidence to suggest that melatonin is an effective treatment for PI. Further research, addressing deficiencies in the current literature, and considering long-term efficacy and safety are necessary before definitive conclusions as to the value of oral melatonin can be drawn.

Comparative Study between the use of Melatonin and A Solution with Melatonin, Tryptophan, and Vitamin B6 as an Inducer of Spontaneous Sleep in Children During an Auditory Response Test: An Alternative to Commonly Used Sedative Drugs

“…This molecule is able to result in the correct performance of the examination without representing a risk factor for the child and a major expense for the National Health System [5] . Melatonin is a hormone (N-acetyl-5-methoxytryptamine) synthesized by the pineal gland whose secretion is regulated by the suprachiasmatic nucleus of the hypothalamus and has a peak between 2 and 3 a.m. [17,18] . It is metabolized in the liver, and 80-90% of it is converted to 6-sulfatoxymelatonin [19] , an inactive component excreted in the urine.…”

Evidence for the efficacy of melatonin in the treatment of primary adult sleep disorders

“…It is strongly recommended long term drug therapy should also be avoided, as dependence and tolerance can develop. [2,3] Previous studies have highlighted the potential use of melatonin in treating primary and secondary [4] sleep disorders in adults [5,6,7] and others have indicated melatonin can decrease sleep onset latency and increase the total time asleep, thus improving sleep quality overall. [8] Ferracioli-Oda et al [9] verified using melatonin in adults with primary sleep disorders improves sleep parameters (i.e., a higher dose has a greater effect on sleep latency and total sleep time).…”

The Use of Melatonin for Sedation During Auditory Brainstem Response Testing: An Alternative to Sedation in Non-Medical Settings?

“…Melatonin is an endogenous hormone which is naturally produced by the pineal gland. 12,13 Its major function is to control the sleep-wake cycle. 14 However, an exogenous version is available for individuals with sleep disorders and sleep-related medical requirements, 14,13 as well as to ease jetlag.…”

“…12,13 Its major function is to control the sleep-wake cycle. 14 However, an exogenous version is available for individuals with sleep disorders and sleep-related medical requirements, 14,13 as well as to ease jetlag. 12 It has been reported that exogenous melatonin (in the form of a hormonal supplement) 13 treats reduced sleep onset latency, increases sleep efficiency as well as sleep duration in humans.…”

“…8 Long term use of melatonin has also not shown major side-effects. 17,18 The most frequently reported side effects of melatonin are "hangover effects", 13 drowsiness, dizziness, nausea, and headaches, 19 fatigue, 20 and decreased concentration. 21 Similarly, research has indicated that exogenous melatonin is safe for individuals to use on a shortterm basis (over a period of days or weeks).…”