Taking melatonin resulted in small increases in total sleep time, sleep onset latency, and sleep efficiency in adults with insomnia over age 55.
Over-the-counter melatonin appears to provide a measure of sleep for older individuals who have insomnia, a meta-analysis showed.
Among individuals 55 and older, treatment with melatonin significantly improved sleep onset (by 6.36 minutes) and total sleep time (by 18.29 minutes), according to Jennifer Brault, MD, a resident in psychiatry at the University of Ottawa.
Sleep efficiency was improved by 3.54 percent, she reported in a poster presentation at the annual meeting of the Associated Professional Sleep Societies.
“When I first saw these numbers, I thought, ‘well, it is statistically significant, but is it clinically significant?’ ” Brault told MedPage Today. “But when I went and looked at the results for benzodiazepines [drugs often prescribed as sedatives] – the numbers are similar. So now I think these results may be more significant than I originally thought.”
Brault indicated that there were very few side effects reported but, she said, “at this point in our work we are not ready to make recommendations as to whether older individuals should take melatonin if they experience insomnia.”
Sleep regulation changes with age, which can lead to increased daytime sleepiness, memory problems, and mood changes. But, although melatonin is a key hormone involved in regulating circadian rhythms and has been reported to have soporific effects, previous studies in older adults have yielded mixed results, Brault said.
So she and her colleagues began scouring medical literature on the subject. They found nine studies enrolling 297 patients.
In general, the people who used melatonin in the trials took the hormone supplements around dinner time.
Although dosing was all over the lot – from 0.1 mg to 10 mg — Brault said they were unable to observe a difference in outcomes based on dose. The researchers also saw no impact of melatonin on waking after sleep onset.
“I don’t think there is any problem with using melatonin in the short term for treatment of insomnia or to get over such things as jet lag,” Olivier Vanderveken, MD, a sleep medicine specialist at the University of Antwerp in Antwerp, Belgium, told MedPage Today. “However, I am not sure about long-term use of melatonin. I am not aware of any studies in long-term treatment.”
Vanderveken said that with long-term treatment, unexpected adverse events might emerge.
Brault said the next phase of their trial will look at subjective data such as sleep logs and whether participants felt they had a better night’s sleep or if they had more energy the next day.
By Ed Susman
MAY