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Review
, 33 (12), 1605-14

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

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Review

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

Ingeborg M van Geijlswijk et al. Sleep.

Abstract

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.

Keywords: Melatonin; delayed sleep phase disorder; meta-analysis.

Figures

Figure 1
Figure 1
Study selection
Figure 2
Figure 2
Dim Light Melatonin Onset in patients with delayed sleep phase disorder. MD, Mean difference (h); IV, inverse variance; t, estimate of the between study variance where the weight (W) given to each study is calculated by the inverse sum of the within study and between study variance estimates.
Figure 3
Figure 3
Clock hour of sleep onset in patients with delayed sleep phase disorder. MD, Mean difference (h); IV, inverse variance; t, estimate of the between study variance where the weight (W) given to each study is calculated by the inverse sum of the within study and between study variance estimates.
Figure 4
Figure 4
Wake up time in patients with delayed sleep phase disorder. MD, Mean difference (h); IV, inverse variance; t, estimate of the between study variance where the weight (W) given to each study is calculated by the inverse sum of the within study and between study variance estimates.
Figure 5
Figure 5
Sleep onset latency in patients with delayed sleep phase disorder. MD, Mean difference (h); IV, inverse variance; t, estimate of the between study variance where the weight (W) given to each study is calculated by the inverse sum of the within study and between study variance estimates.
Figure 6
Figure 6
Total sleep time in patients with delayed sleep phase disorder. MD, Mean difference (h); IV, inverse variance; t, estimate of the between study variance where the weight (W) given to each study is calculated by the inverse sum of the within study and between study variance estimates.

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