6‐Sulfatoxymelatonin excretion and self‐reported sleep in good sleeping controls and 55–80‐year‐old insomniacs

Abstract

The pineal hormone melatonin is thought to play a role in sleep initiation and maintenance. This was examined in a large sample of good sleeping controls ( n=52) and sleep maintenance insomniacs (n=56), aged 55–80 y. Subjects collected 5 d of self‐reported sleep diary measures, and 12‐h urine samples (08.00–20.00 and 20.00–08.00 h) for analysis of the urinary melatonin metabolite, 6‐sulphatoxymelatonin (aMT.6S). Insomniacs reported a significantly greater amount of wake after sleep onset, less sleep in total, less efficient sleep and poorer quality sleep compared to controls. However, no significant differences in melatonin excretion were observed between controls and insomniacs, with both groups showing similar mean (SEM) 12‐h night‐time [30.9 (2.9) vs. 30.6 (3.3) nmoles, respectively] as well as 24‐h total [38.7 (3.4) vs. 36.7 (3.8)] aMT.6S excretion levels. No significant correlations were observed with any sleep parameters nor any effects of medication (anti‐inflammatory agents, hormone replacement therapy, and an undifferentiated group of medications). The present results do not support a simple relationship between total melatonin production and self‐reported sleep quality and duration in the aged.

Age‐Related Changes of Circadian Rhythms and Sleep‐Wake Cycles

“…Amplitudes of melatonin and cortisol excretion in older adults were also smaller in the present study than those of young adults, but there was no correlation between amplitudes of cortisol and melatonin excretion and home sleep parameters. The mesor of aMT6s showed no correlation with TST or WASO in either age group, which is consistent with other reports that the amount of melatonin excreted is not a factor in sleep disturbance 34,35 …”

A New Concept for Melatonin Deficit On Pineal Calcification and Melatonin Excretion

“…But, our hypothetical framework might explain why low melatonin secretion does not predict response to melatonin replacement therapy (Garfinkel et al 1995;Hughes et al 1998;Lushington et al 1998;Youngstedt et al 1998). Some evidence for the validity of our hypothesis comes from the preliminary finding that high pineal DOC is related to disturbances of the sleep-wake cycle (Kunz et al 1998).…”

“…In particular, this drug delays circadian rhythms when administered in the morning and advances them when administered in the afternoon or early evening according to a phase response curve (PRC), which is nearly opposite in phase to the PRC's for light exposure (Lewy et al 1992). Melatonin has proven to exert a chronobiotic mode of action (Dawson and Armstrong 1996) by its ability to facilitate the post-flight adaptation to jet-lag (Arendt et al 1986), to phase advance the sleep of patients suffering from a phase-delay syndrome (Dahlitz et al 1991;Tzischinsky et al 1993), and to re-entrain the sleep-wake cycle of patients with a non-24-hour rhythm, such as in the blind, to the environmental light-dark cycle (Arendt et al 1988;Lapierre and Dumont 1995;McArthur et al 1996).However, in only one of the clinical studies (Haimov et al 1995), in which exogenous melatonin proved usefulness, did low endogenous melatonin excretion predict response (Garfinkel et al 1995;Hughes et al 1998 Lushington et al 1998;Youngstedt et al 1998). Furthermore, normative data as to the amount of melatonin secretion demonstrate a huge inter-individual variability in humans (Dawson et al 1992;Bergiannaki et al 1995;Smith et al 1997).…”

“…However, in only one of the clinical studies (Haimov et al 1995), in which exogenous melatonin proved usefulness, did low endogenous melatonin excretion predict response (Garfinkel et al 1995;Hughes et al 1998;Lushington et al 1998;Youngstedt et al 1998). Furthermore, normative data as to the amount of melatonin secretion demonstrate a huge inter-individual variability in humans (Dawson et al 1992;Bergiannaki et al 1995;Smith et al 1997).…”

Tackling sleeplessness: psychological treatment options for insomnia in older adults

“…For example, there is evidence, though limited, that diurnal melatonin levels are indeed disrupted in older adults with insomnia. 84 Exogenous (eg, bright light, exercise, and social activity) and endogenous (eg, melatonin excretion, body temperature) factors that contribute to the circadian sleep drive are commonly altered in late-life. Exogenous changes in the circadian sleep process may result from lifestyle and/or illness.…”