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Effects of exogenous melatonin on sleep: a meta-analysis.

Abstract
Exogenous melatonin reportedly induces drowsiness and sleep, and may ameliorate sleep disturbances, including the nocturnal awakenings associated with old age. However, existing studies on the soporific efficacy of melatonin have been highly heterogeneous in regard to inclusion and exclusion criteria, measures to evaluate insomnia, doses of the medication, and routes of administration. We reviewed and analyzed (by meta-analysis) available information on effects of exogenous melatonin on sleep. A MEDLINE search (1980 to December 2003) provided English-language articles, supplemented by personal files maintained by the authors. The analysis used information derived from 17 different studies (involving 284 subjects) that satisfied inclusion criteria. Sleep onset latency, total sleep duration, and sleep efficiency were selected as the outcome measures. The study effect size was taken to be the difference between the response on placebo and the mean response on melatonin for each outcome measured. Melatonin treatment significantly reduced sleep onset latency by 4.0 min (95% CI 2.5, 5.4); increased sleep efficiency by 2.2% (95% CI 0.2, 4.2), and increased total sleep duration by 12.8 min (95% CI 2.9, 22.8). Since 15 of the 17 studies enrolled healthy subjects or people with no relevant medical condition other than insomnia, the analysis was also done including only these 15 studies. The sleep onset results were changed to 3.9 min (95% CI (2.5, 5.4)); sleep efficiency increased to 3.1% (95% CI (0.7, 5.5)); sleep duration increased to 13.7 min (95% CI (3.1, 24.3)).
AuthorsAmnon Brzezinski, Mark G Vangel, Richard J Wurtman, Gillian Norrie, Irina Zhdanova, Abraham Ben-Shushan, Ian Ford
JournalSleep medicine reviews (Sleep Med Rev) Vol. 9 Issue 1 Pg. 41-50 (Feb 2005) ISSN: 1087-0792 [Print] England
PMID15649737 (Publication Type: Journal Article, Meta-Analysis, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't, Research Support, U.S. Gov't, P.H.S.)
Chemical References
  • Melatonin
Topics
  • Cross-Over Studies
  • Dose-Response Relationship, Drug
  • Drug Administration Schedule
  • Humans
  • Melatonin (administration & dosage)
  • Randomized Controlled Trials as Topic
  • Reference Values
  • Sleep (drug effects)
  • Sleep Disorders, Circadian Rhythm (drug therapy)
  • Sleep Initiation and Maintenance Disorders (drug therapy)
  • Treatment Outcome

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