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Review
. 2015 Aug;30(5):439-47.
doi: 10.1177/1533317514568005.

Melatonin for sleep disorders and cognition in dementia: a meta-analysis of randomized controlled trials

Jing Xu  1 , Li-Ling Wang, Eric B Dammer, Chun-Bo Li, Gang Xu, Sheng-Di Chen, Gang Wang
Affiliations
Review

Melatonin for sleep disorders and cognition in dementia: a meta-analysis of randomized controlled trials

Jing Xu et al. Am J Alzheimers Dis Other Demen. 2015 Aug.

Abstract

The current review aims to examine melatonin therapy for both sleep disturbances and cognitive function in dementia. We searched all randomized controlled trials published in Medline, Embase, the Cochrane Library, China National Knowledge Infrastructure, the Cochrane Dementia and Cognitive Improvement Group’s Specialized Register, and Clinical Trials.gov. The grading of recommendations assessment, development and evaluation framework was used to assess the quality of evidence. Seven studies were included (n = 520). Treated participants showed prolonged total sleep time (TST) by 24.36 minutes (P = .02). Sleep efficacy (SE) was marginally improved (P = .07). This effect was stronger under a longer intervention period lasting more than 4 weeks (P = .02). Conversely, cognitive function did not change significantly. Additionally, there was no report of severe adverse events. Given the current studies, we conclude that melatonin therapy may be effective in improving SE and prolonging TST in patients with dementia; however, there is no evidence that this improvement impacts cognitive function.

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Conflict of interest statement

The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Identification of eligible studies.
Figure 2.
Figure 2.
Effects of exogenous melatonin on sleep efficacy. (A) Melatonin treatment for 10 days to 8 weeks in patients with all-cause dementia; (B) melatonin treatment for at least 4 weeks in patients with all-cause dementia; (C) melatonin treatment for 10 days to 8 weeks in patients with Alzheimer’s disease (AD); and (D) melatonin for 8 weeks in patients with AD. *Riemersma 2008, study 1 represents “placebo vs melatonin” group. Reimersma 2008, study 2 represents “light therapy alone vs melatonin plus light therapy” group. Singer 2003, study 1 represents “placebo vs 2.5 mg sustained-release melatonin” group. Singer 2003, study 2 represents “placebo vs 10 mg immediate-release melatonin” group.
Figure 3.
Figure 3.
Effects of exogenous melatonin on total sleep time. (A) Melatonin treatment for 10 days to 10 weeks in patients with all-cause dementia and (B) melatonin treatment for at least 4 weeks in patients with all-cause dementia. *Riemersma 2008, study 1 represents “placebo vs melatonin” group. Reimersma 2008, study 2 represents “light therapy alone vs melatonin plus light therapy” group. Singer 2003, study 1 represents “placebo vs 2.5 mg sustained-release melatonin” group. Singer 2003, study 2 represents “placebo vs 10 mg immediate-release melatonin” group.
Figure 4.
Figure 4.
Effects of exogenous melatonin on cognitive function in patients with all-cause dementia. (A) Mini-Mental State Examination (MMSE); (B) Alzheimer’s disease Assessment-Cognitive subscale (ADAS-cog). *Riemersma 2008, study 1 represents “placebo vs melatonin” group. Reimersma 2008, study 2 represents “light therapy alone vs melatonin plus light therapy” group. Singer 2003, study 1 represents “placebo vs 2.5 mg sustained-release melatonin” group. Singer 2003, study 2 represents “placebo vs 10 mg immediate-release melatonin” group.
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