Melatonin delayed-sleep-phase syndrome

A number of clinical studies have now made use of the phase advancing property of melatonin for treating delayed sleep phase syndrome (DSPS). Melatonin, at a 5 mg dose, has been found beneficial in advancing the sleep onset time and wake time in DSPS subjects (Dahlitz et al. 1991 Nagtegaal et al. 1998 Kayumov et al. 2001). Melatonin was found to be effective when given five hours before its endogenous onset or seven hours before sleep onset. 

Dahlitz, M., Alvarez, B., Vignau, J. et al. (1991). Delayed sleep phase syndrome response to melatonin. Lancet 337, 1121-4. 

Kayumov, L., Brown, G., Jindal, R., Buttoo, K. Shapiro, C. M. (2001). A randomized, double-blind, placebo-controlled crossover study of the effect of exogenous melatonin on delayed sleep phase syndrome. Psychosom. Med. 63, 40-8. 

Nagtegaal, J. E., Kerkhof, G. A, Smits, M. G., Swart, A. C. van der Meer, Y. G. (1998). Delayed sleep phase syndrome A placebo-controlled cross-over study on the effects of melatonin administered five hours before the individual dim light melatonin onset. J. Sleep Res. 7, 135-43. 

Melatonin has been studied in the treatment of various sleep disorders, including insomnia and delayed sleep-phase syndrome. It has been reported to improve sleep onset, duration, and quality when administered to healthy volunteers, suggesting a pharmacologic hypnotic effect. Melatonin has also been shown to increase rapid-eye-movement (REM) sleep. These observations have been applied to the development of ramel-teon, a prescription hypnotic, which is an agonist at melatonin receptors (see Chapter 22). 

Shibui K, Uchiyama M, Okawa M. Melatonin rhythms in delayed sleep phase syndrome. J Biol Rhythms 1999 14 72-76. 

Oldani A, Ferini-Strambi L, Zucconi M, Stankov B, Fraschini F, Smime S. Melatonin and delayed sleep phase syndrome ambulatory polygraphic evaluation. Neuroreport 1994 6 132-134. 

Dagan Y, Yovel I, Hallis D, Eisenstein M, Raichik I. Evaluating the role of melatonin in the long-term treatment of delayed sleep phase syndrome (DSPS). Chronobiol Int 1998 15 181-190. 

Wasdell MB, Jan JE, Bomben MM, Freeman RD, Rietveld WJ, Tai J, Hamilton D, Weiss MD (2008) A randomized, placebo-controUed trial of controlled release melatonin treatment of delayed sleep phase syndrome and impaired sleep maintenance in children with neurodevelopmental disabilities. J Pineal Res 44 57-64. 

Rahman SA, Kayumov L, Shapiro CM. Antidepressant action of melatonin in the treatment of delayed sleep phase syndrome. Sleep Med 2010 11(2) 131-6. 

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