Improvement of sleep quality in elderly people by controlled-release melatonin

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).…”

“…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).…”

“…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).…”

Abnormal nocturnal melatonin secretion and disordered sleep in abstinent alcoholics

“…It is also possible that delay of sleep onset leads to abnormal melatonin secretion, although this alternative is less likely since early night sleep deprivation does not alter the profile of melatonin secretion as compared to uninterrupted 12 sleep (Redwine et al 2000). Given other experimental evidence that evening administration of melatonin improves sleep quality in the elderly and primary insomniacs (Garfinkel et al 1995;Haimov et al 1995), the present study has important clinical implications relevant to the treatment of disordered sleep in alcoholics.…”

“…Melatonin is thought to have effects on sleep by resetting the internal biological clock (Brzezinski, 1997), whereas circulating concentrations of cortisol are not reliably associated with sleep measures of continuity (Friess et al 1995). Indeed, early evening administration of melatonin has been found to decrease sleep latency and increase sleep efficiency in the elderly (Zhdanova et al 2001) and in patients with primary insomnia (Garfinkel et al 1995;Haimov et al 1995;Zhdanova et al 1995;Girardin et al 1998) but have no effects on measures of sleep architecture or REM sleep (Zhdanova et al 2001). Likewise, in older adults and psychiatric populations such as depressed patients, melatonin onset and/or peak values are altered in association with disturbances of sleep continuity (Nair et al 1984;Beck-Friis et al 1985;Kennedy et al 1989;Dijk et al 1999).…”