Entrainment of Free-Running Circadian Rhythms by Melatonin in Blind People

Sack, Robert L.; Brandes, Richard W.; Kendall, Adam R.; Lewy, Alfred J.

doi:10.1056/nejm200010123431503

Cited by 444 publications

(269 citation statements)

References 22 publications

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“…It is speculated that the use of melatonin has no effect when used on nights when the circadian rhythm is congruent with pre-established/routine sleep habits, reinforcing the concept that melatonin does not provoke sleep but facilitates the desire to sleep when awake. [55] The overall estimated score of treatment effect for these patients was not significant (Z=0.71, P=0.48). No significant heterogeneity was found between these compared studies ( =0.00, P=0.99, I 2 =0%).…”

Section: A C C E P T E D Accepted Manuscriptmentioning

confidence: 82%

“…In comparison, Sack et al [55] used PSG which increased reliability of the findings despite the similarly small sample size (n=7). A reduction in total sleep time after melatonin administration was also shown, due to melatonin inducing additional consolidated sleep in blind patients and shortening their overall sleep time by reducing frequency of daytime napping.…”

Section: A C C E P T E D Accepted Manuscriptmentioning

confidence: 99%

“…[32] Timed melatonin also successfully entrained rhythms in blind individuals. [33,34] Primary Insomnia 2. Non-benzodiazepine agonists and MT1/MT2 receptor agonists are safer for long term use than traditional benzodiazepines.…”

Section: Non-rem Parasomniamentioning

confidence: 99%

“…One study used adolescents and young adults (aged 16-25) [69,70] Three studies [54,55,58] highlighted the use of melatonin in phase advancement and entrainment of circadian rhythm in patients who are blind. Two of these trials [54,55] were eligible for meta-analysis.…”

Section: A C C E P T E D Accepted Manuscriptmentioning

confidence: 99%

“…Two of these trials [54,55] were eligible for meta-analysis. There was no overall significant difference between the effects of melatonin and placebo on sleep onset latency in blind patients (total mean difference = -3.17 minutes, 95% CI: -11.88-5.54).…”

Section: A C C E P T E D Accepted Manuscriptmentioning

confidence: 99%

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

Auld

Maschauer

Morrison

et al. 2017

Sleep Medicine Reviews

316

142

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Melatonin is a physiological hormone involved in sleep timing and is currently used exogenously in the treatment of primary and secondary sleep disorders with empirical evidence of efficacy, but very little evidence from randomised, controlled studies. The aim of this meta-analysis was to assess the evidence base for the therapeutic effects of exogenous melatonin in treating primary sleep disorders. An electronic literature review search of MEDLINE (1950-present) EMBASE (1980- present), PsycINFO (1987- present), and SCOPUS (1990- present), along with a hand-searching of key journals was performed in July 2013 and then again in May 2015. This identified all studies that compared the effect of exogenous melatonin and placebo in patients with primary insomnia, delayed sleep phase syndrome, Non 24- hour sleep wake syndrome in people who are blind, and REM-Behaviour Disorder. Meta-analyses were performed to determine the effect of magnitude in studies of melatonin in improving sleep. A total of 5030 studies were identified; of these citations, 13 were included for review based on the inclusion criteria of being: double or single-blind, randomised and controlled. Results from the meta-analyses showed the most convincing evidence for exogenous melatonin use was in reducing sleep onset latency in primary insomnia (p=0.002), delayed sleep phase syndrome (p<0.0001), and regulating the sleepwake patterns in blind patients compared with placebo. These findings highlight the potential importance of melatonin in treating certain first degree sleep disorders. The development of large-scale, randomised, controlled trials is recommended to provide further evidence for therapeutic use of melatonin in a variety of sleep difficulties

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Section: A C C E P T E D Accepted Manuscriptmentioning

confidence: 82%

Section: A C C E P T E D Accepted Manuscriptmentioning

confidence: 99%

Section: Non-rem Parasomniamentioning

confidence: 99%

Section: A C C E P T E D Accepted Manuscriptmentioning

confidence: 99%

Section: A C C E P T E D Accepted Manuscriptmentioning

confidence: 99%

See 3 more Smart Citations

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

Auld

Maschauer

Morrison

et al. 2017

Sleep Medicine Reviews

316

142

View full text Add to dashboard Cite

show abstract

Ramelteon for insomnia

Takeshima

Furukawa

Hayasaka

et al. 2014

Cochrane Database of Systematic Reviews

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Melatonin Receptors in Central Nervous System

Dubocovich

2007

Handbook of Contemporary Neuropharmacology

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The functional role of melatonin receptors in the mammalian central nervous system and their therapeutic potential is discussed. Melatonin, dubbed the “hormone of darkness,” is produced primarily in the pineal gland and retina following circadian rhythms with high levels of night. The chapter describes the structure, molecular pharmacology, signaling, and function of the MT1 and MT2 mammalian melatonin receptors. This is followed by discussion of recent advances in the regulation of melatonin receptor sensitivity and its role in circadian rhythm modulation by the circadian timing system. Recent advances in the discovery and development of therapeutic agents targeting melatonin receptors for the treatment of insomnia, circadian rhythm dysfunctions, and depression are also highlighted.

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Entrainment of Free-Running Circadian Rhythms by Melatonin in Blind People

Abstract: Administration of melatonin can entrain circadian rhythms in most blind people who have free-running rhythms.

Cited by 444 publications

References 22 publications

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

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

Ramelteon for insomnia

Melatonin Receptors in Central Nervous System

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