Muller MD, Sauder CL, Ray CA. Melatonin attenuates the skin sympathetic nerve response to mental stress. Am J Physiol Heart Circ Physiol 305: H1382-H1386, 2013. First published August 30, 2013 doi:10.1152/ajpheart.00470.2013.-Melatonin attenuates muscle sympathetic nerve responses to sympathoexcitatory stimuli, but it is unknown whether melatonin similarly attenuates reflex changes in skin sympathetic nerve activity (SSNA). In this double-blind, placebo-controlled, crossover study, we tested the hypothesis that melatonin (3 mg) would attenuate the SSNA response to mental stress (mental arithmetic). Twelve healthy subjects underwent experimental testing on two separate days. Three minutes of mental stress occurred before and 45 min after ingestion of melatonin (3 mg) or placebo. Skin temperature was maintained at 34°C. Reflex increases in SSNA (peroneal nerve), mean arterial pressure, and heart rate (HR) to mental stress before and after melatonin were determined. Melatonin lowered HR (pre, 66 Ϯ 3 beats/min; and post, 62 Ϯ 3 beats/min, P ϭ 0.046) and SSNA (pre, 14,282 Ϯ 3,706 arbitrary units; and post, 9,571 Ϯ 2,609 arbitrary units, P ϭ 0.034) at rest. In response to mental stress, SSNA increases were significantly attenuated following melatonin ingestion (second minute, 114 Ϯ 30 vs. 74 Ϯ 14%; and third minute, 111 Ϯ 29 vs. 54 Ϯ 12%, both P Ͻ 0.05). The mean arterial pressure increase to mental stress was blunted in the third minute (20 Ϯ 2 vs. 17 Ϯ 2 mmHg, P ϭ 0.032), and the HR increase was blunted in the first minute (33 Ϯ 3 vs. 29 Ϯ 3 beats/min, P ϭ 0.034) after melatonin. In summary, exogenous melatonin attenuates the SSNA response to mental stress. autonomic nervous system; blood pressure; heart rate MELATONIN IS AN ENDOGENOUS hormone secreted by the pineal gland in a circadian rhythm. This hormone is mechanistically linked to the sleep-wake cycle, and peak plasma levels are evident in the early morning (1:00 to 5:00 AM) (19,27). For this reason, melatonin is commonly ingested in high doses to improve sleep (i.e., 3 to 5 mg, which leads to Ͼ50 times above physiological levels). In addition to its effectiveness as a sleep aid, mounting evidence suggests that exogenous melatonin has widespread effects on immune response, aging, and cancer (c.f., 7, 37). Furthermore, melatonin supplementation has been reported to reduce blood pressure in patients with metabolic syndrome (20) and essential hypertension (30). One mechanism by which melatonin decreases blood pressure could be its effect on cardiovascular reflexes.In previous studies, our laboratory demonstrated that melatonin attenuated increases in muscle sympathetic nerve activity (MSNA) to both lower body negative pressure (24) and headdown rotation (14). These findings suggest that melatonin attenuates reflex changes in sympathetic outflow during postural change. However, the effect of melatonin on reflex changes in skin sympathetic nerve activity (SSNA) is unknown. The interaction of melatonin on SSNA is important to understand because both participate in t...