Sleep-promoting effects of melatonin: At what dose, in whom, under what conditions, and by what mechanisms?

• Published in: Sleep (New York, N.Y.) Vol. 20; no. 10; pp. 908 - 915
• Main Authors: SACK, R. L, HUGHES, R. J, EDGAR, D. M, LEWY, A. J
• Format: Journal Article
• Language: English
• Published: Rochester, MN American Academy of Sleep Medicine 01-10-1997
• Subjects: Adult; Aged; Biological and medical sciences; Body Temperature Regulation - drug effects; Circadian Rhythm - drug effects; gamma-Aminobutyric Acid - drug effects; Hormones. Endocrine system; Humans; Hypnotics and Sedatives - therapeutic use; Medical sciences; Melatonin - pharmacology; Melatonin - therapeutic use; Middle Aged; Pharmacology. Drug treatments; Sleep Initiation and Maintenance Disorders - drug therapy; Suprachiasmatic Nucleus - drug effects; Human; Vigilance; Melatonin; Treatment efficiency; Central nervous system; Sleep disorder; Biological rhythm; Hypothalamus; Review; Circadian rhythm; Dose activity relation; Insomnia; Supraoptic nucleus; Brain (vertebrata); Pineal hormone
• ISSN: 0161-8105; 1550-9109
• DOI: 10.1093/sleep/20.10.908

Differing conclusions regarding the sleep-promoting effects of melatonin may be the result of the broad range of doses employed (0.1-2000 mg), the differing categories of subjects tested (normal subjects, insomniac patients, elderly, etc.), and the varying times of administration (for daytime vs. nighttime sleep). We conclude that melatonin may benefit sleep by correcting circadian phase abnormalities and/or by a modest direct soporific effect that is most evident following daytime administration to younger subjects. We speculate that these effects are mediated by interactions with specific receptors concentrated in the suprachiasmatic nucleus (SCN) that result in resetting of the circadian pacemaker and/or attenuation of an SCN-dependent circadian alerting process.