SLEEP - The Use of Exogenous Melatonin in Delayed Sleep Phase Disorder: A Meta-analysis

VOLUME 33, ISSUE 12

REVIEW
The Use of Exogenous Melatonin in Delayed Sleep Phase Disorder: A Meta-analysis

Ingeborg M. van Geijlswijk, PharmD¹^,²; Hubert P. L. M. Korzilius, PhD³; Marcel G. Smits, PhD⁴

¹Faculty of Veterinary Medicine, Pharmacy Department, Utrecht University, Utrecht, The Netherlands; ²Utrecht Institute for Pharmaceutical Sciences (UIPS), Department of Pharmacoepidemiology and Pharmacotherapy, Faculty of Science, Utrecht University, Utrecht, The Netherlands; ³Radboud University Nijmegen, Institute for Management Research, Nijmegen, The Netherlands; ⁴Hospital Gelderse Vallei, Department of Sleep-wake Disorders and Chronobiology, Ede, The Netherlands

Table of Contents

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Study Objectives:

To perform a meta-analysis of the efficacy and safety of exogenous melatonin in advancing sleep-wake rhythm in patients with delayed sleep phase disorder.

Design:

Meta analysis of papers indexed for PubMed, Embase, and the abstracts of sleep and chronobiologic societies (1990–2009).

Patients:

Individuals with delayed sleep phase disorder.

Interventions:

Administration of melatonin.

Measurements and Results:

A meta-analysis of data of randomized controlled trials involving individuals with delayed sleep phase disorder that were published in English, compared melatonin with placebo, and reported 1 or more of the following: endogenous melatonin onset, clock hour of sleep onset, wake-up time, sleep-onset latency, and total sleep time. The 5 trials including 91 adults and 4 trials including 226 children showed that melatonin treatment advanced mean endogenous melatonin onset by 1.18 hours (95% confidence interval [CI]: 0.89–1.48 h) and clock hour of sleep onset by 0.67 hours (95% CI: 0.45–0.89 h). Melatonin decreased sleep-onset latency by 23.27 minutes (95% CI: 4.83 –41.72 min). The wake-up time and total sleep time did not change significantly.

Conclusions:

Melatonin is effective in advancing sleep-wake rhythm and endogenous melatonin rhythm in delayed sleep phase disorder.

Citation:

van Geijlswijk IM; Korzilius HPLM; Smits MG. The use of exogenous melatonin in delayed sleep phase disorder: a meta-analysis. SLEEP 2010;33(12):1605-1614.

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