Role of Melatonin in the Management of Sleep and Circadian Disorders in the Context of Psychiatric Illness.
Circadian disorder
Circadian rhythm
Melatonergic agents
Melatonin
Psychiatric illness
Sleep
Journal
Current psychiatry reports
ISSN: 1535-1645
Titre abrégé: Curr Psychiatry Rep
Pays: United States
ID NLM: 100888960
Informations de publication
Date de publication:
11 2022
11 2022
Historique:
accepted:
22
08
2022
pubmed:
14
10
2022
medline:
8
11
2022
entrez:
13
10
2022
Statut:
ppublish
Résumé
We present a review of research on the role of melatonin in the management of sleep and circadian disorders, stressing current overall view of the knowledge across psychiatric disorders. Dysregulation of sleep and circadian rhythms has been established in several psychiatric and neurocognitive disorders for long. Recent research confirms this finding consistently across disorders. The secretion of melatonin in schizophrenia and neurocognitive disorders is reduced due to a smaller volume and enlarged calcification of the pineal gland. On the other hand, melatonin dysregulation in bipolar disorder may be more dynamic and caused by light-sensitive melatonin suppression and delayed melatonin secretion. In both cases, exogenous melatonin seems indicated to correct the dysfunction. However, a very limited number of well-designed trials with melatonin to correct sleep and circadian rhythms exist in psychiatric disorders, and the evidence for efficacy is robust only in autism, attention deficit hyperactivity disorder (ADHD), and neurocognitive disorders. This topic has mainly not been of interest for recent work and well-designed trials with objective circadian parameters are few. Overall, recent studies in psychiatric disorders reported that melatonin can be effective in improving sleep parameters such as sleep onset latency, sleep efficiency, and sleep quality. Recent meta-analysis suggests that optimal dosage and dosing time might be important to maximize the efficacy of melatonin. The knowledge base is sufficient to propose well-designed, larger trials with circadian parameters as inclusion and outcome criteria. Based on the partly fragmentary information, we propose testing efficacy in disorders with neurocognitive etiopathology with later and higher dosing, and affective and anxiety disorders with lower and earlier dosing of melatonin. Melatonin is promising for the correction of sleep and circadian abnormalities in psychiatric disorders. However, research results on its effect are still few and need to be accumulated. For effective use of melatonin, it is necessary to consider the appropriate dosage and administration time, depending on the individual abnormality of sleep and circadian rhythms.
Identifiants
pubmed: 36227449
doi: 10.1007/s11920-022-01369-6
pii: 10.1007/s11920-022-01369-6
pmc: PMC9633504
doi:
Substances chimiques
Melatonin
JL5DK93RCL
Types de publication
Journal Article
Review
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
623-634Informations de copyright
© 2022. The Author(s).
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