Does melatonin improve sleep?: Muddles with melatonin

doi:10.1136/bmj.332.7540.550-a

BMJ 2006;332:550 (4 March), doi:10.1136/bmj.332.7540.550-a

Letter

Does melatonin improve sleep?

Muddles with melatonin

The first 150 words of the full text of this article appear below.

EDITOR—Buscemi et al assert that there is no evidencebase for exogenous melatonin for secondary sleep disorder.¹

Lewy et al have shown that low doses of melatonin (0.5 mg) resetcircadian rhythm but not high doses (2 mg).² The prolonged halflife of melatonin and the sensitivity of the circadian rhythmto its presence mean that in trying to achieve phase advancementor phase delay melatonin has a limited window of opportunity.Too low a dose and no effect, too high and the chronobiologicaleffects are lost and only the direct somnolent action is experienced.

Until very recently there have been no commercially availablepreparations of the correct dose, substantially hindering research.As melatonin is of most use where there is circadian rhythmdysregulation the correct dose must be used at the right time.It would be a shame if a potentially useful treatment for alimited range . . . [Full text of this article]

M E Jan Wise, consultant psychiatrist

London NW6 6BX jan.wise@nhs.net

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