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The efficacy and safety of exogenous melatonin for primary sleep disorders. A meta-analysis.

Abstract

BACKGROUND

Exogenous melatonin has been increasingly used in the management of sleep disorders.

PURPOSE

To conduct a systematic review of the efficacy and safety of exogenous melatonin in the management of primary sleep disorders.

DATA SOURCES

A number of electronic databases were searched. We reviewed the bibliographies of included studies and relevant reviews and conducted hand-searching.

STUDY SELECTION

Randomized controlled trials (RCTs) were eligible for the efficacy review, and controlled trials were eligible for the safety review.

DATA EXTRACTION

One reviewer extracted data, while the other verified data extracted. The Random Effects Model was used to analyze data.

DATA SYNTHESIS

Melatonin decreased sleep onset latency (weighted mean difference [WMD]: -11.7 minutes; 95% confidence interval [CI]: -18.2, -5.2)); it was decreased to a greater extent in people with delayed sleep phase syndrome (WMD: -38.8 minutes; 95% CI: -50.3, -27.3; n=2) compared with people with insomnia (WMD: -7.2 minutes; 95% CI: -12.0, -2.4; n=12). The former result appears to be clinically important. There was no evidence of adverse effects of melatonin.

CONCLUSIONS

There is evidence to suggest that melatonin is not effective in treating most primary sleep disorders with short-term use (4 weeks or less); however, additional large-scale RCTs are needed before firm conclusions can be drawn. There is some evidence to suggest that melatonin is effective in treating delayed sleep phase syndrome with short-term use. There is evidence to suggest that melatonin is safe with short-term use (3 months or less).

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  • Authors+Show Affiliations

    ,

    Capital Health Evidence-based Practice Centre, Department of Pediatrics, University of Alberta, Edmonton, AB, Canada. nina.buscemi@ualberta.ca

    , , , , , , ,

    Source

    Journal of general internal medicine 20:12 2005 Dec pg 1151-8

    MeSH

    Humans
    Hypnotics and Sedatives
    Melatonin
    Sleep Wake Disorders
    Treatment Outcome

    Pub Type(s)

    Journal Article
    Meta-Analysis
    Research Support, N.I.H., Extramural
    Research Support, U.S. Gov't, P.H.S.
    Systematic Review

    Language

    eng

    PubMed ID

    16423108

    Citation

    Buscemi, Nina, et al. "The Efficacy and Safety of Exogenous Melatonin for Primary Sleep Disorders. a Meta-analysis." Journal of General Internal Medicine, vol. 20, no. 12, 2005, pp. 1151-8.
    Buscemi N, Vandermeer B, Hooton N, et al. The efficacy and safety of exogenous melatonin for primary sleep disorders. A meta-analysis. J Gen Intern Med. 2005;20(12):1151-8.
    Buscemi, N., Vandermeer, B., Hooton, N., Pandya, R., Tjosvold, L., Hartling, L., ... Vohra, S. (2005). The efficacy and safety of exogenous melatonin for primary sleep disorders. A meta-analysis. Journal of General Internal Medicine, 20(12), pp. 1151-8.
    Buscemi N, et al. The Efficacy and Safety of Exogenous Melatonin for Primary Sleep Disorders. a Meta-analysis. J Gen Intern Med. 2005;20(12):1151-8. PubMed PMID: 16423108.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - The efficacy and safety of exogenous melatonin for primary sleep disorders. A meta-analysis. AU - Buscemi,Nina, AU - Vandermeer,Ben, AU - Hooton,Nicola, AU - Pandya,Rena, AU - Tjosvold,Lisa, AU - Hartling,Lisa, AU - Baker,Glen, AU - Klassen,Terry P, AU - Vohra,Sunita, PY - 2006/1/21/pubmed PY - 2006/7/26/medline PY - 2006/1/21/entrez SP - 1151 EP - 8 JF - Journal of general internal medicine JO - J Gen Intern Med VL - 20 IS - 12 N2 - BACKGROUND: Exogenous melatonin has been increasingly used in the management of sleep disorders. PURPOSE: To conduct a systematic review of the efficacy and safety of exogenous melatonin in the management of primary sleep disorders. DATA SOURCES: A number of electronic databases were searched. We reviewed the bibliographies of included studies and relevant reviews and conducted hand-searching. STUDY SELECTION: Randomized controlled trials (RCTs) were eligible for the efficacy review, and controlled trials were eligible for the safety review. DATA EXTRACTION: One reviewer extracted data, while the other verified data extracted. The Random Effects Model was used to analyze data. DATA SYNTHESIS: Melatonin decreased sleep onset latency (weighted mean difference [WMD]: -11.7 minutes; 95% confidence interval [CI]: -18.2, -5.2)); it was decreased to a greater extent in people with delayed sleep phase syndrome (WMD: -38.8 minutes; 95% CI: -50.3, -27.3; n=2) compared with people with insomnia (WMD: -7.2 minutes; 95% CI: -12.0, -2.4; n=12). The former result appears to be clinically important. There was no evidence of adverse effects of melatonin. CONCLUSIONS: There is evidence to suggest that melatonin is not effective in treating most primary sleep disorders with short-term use (4 weeks or less); however, additional large-scale RCTs are needed before firm conclusions can be drawn. There is some evidence to suggest that melatonin is effective in treating delayed sleep phase syndrome with short-term use. There is evidence to suggest that melatonin is safe with short-term use (3 months or less). SN - 1525-1497 UR - https://www.unboundmedicine.com/medline/citation/16423108/full_citation L2 - https://onlinelibrary.wiley.com/resolve/openurl?genre=article&sid=nlm:pubmed&issn=0884-8734&date=2005&volume=20&issue=12&spage=1151 DB - PRIME DP - Unbound Medicine ER -