[Melatonin--a natural hypnotic?]

Abstract

The hypnogenic effects of melatonin are well documented in human pharmacological studies in normal volunteers after daytime parenteral and oral administration of pharmacological, supraphysiological and physiological doses. The findings after evening administration are not so unequivocal. From the clinical point of view, melatonin proved effective in double-blind, placebo-controlled trials in 2 types of sleep disorder: 1) as a chronobiotic in circadian rhythm sleep disorders such as jet lag-syndrome, shift-worker sleep disorder, delayed sleep phase syndrome and non-24-hour sleep-wake disorder; 2) as a hypnotic for insomnia in elderly patients with a relative melatonin deficit. Interactions with other psychotropic drugs are described and a potential indication in polymorbid patients with concomitant insomnia and sleep-related breathing disorders is suggested. More controlled studies are necessary on the effects, therapeutic efficacy and tolerability of melatonin in the treatment of the many different sleep disorders.