Influence of chronic ?-adrenoreceptor blocker treatment on melatonin secretion and sleep quality in patients with essential hypertension

Abstract

The nocturnal production of melatonin synthesis has been associated with circadian mechanisms of the organization of sleep. It is well known that the synthesis of melatonin is under the control of pineal beta 1-adrenoreceptors. In this study the effect of ten weeks treatment with the beta-adrenoreceptor (beta-AR) blockers propranolol and ridazolol on melatonin synthesis and on sleep quality was examined in 42 patients suffering from essential hypertension. Before and after 6 and 10 weeks of beta-AR-blocker administration urinary sulfatoxymelatonin excretion rates were measured and sleep factors were evaluated by using a standardized sleep inventory consisting of self-rating sleepiness scales. After 6 and 10 weeks of treatment, a significant about 50 percent reduction of sulfatoxymelatonin was measured. No relationship between these reductions and changes in sleep factors was found. The results indicate that a reduced nightly amplitude of melatonin has minor significance for the organization of physiological sleep. Furthermore, it is suggested that pineal mechanisms beside the beta 1-adrenergic receptor transduction system serve to maintain the melatonin signal to a considerable extent during a chronic beta 1-AR blockade.

Pineal Gland Volume Assessed by MRI and Its Correlation with 6-Sulfatoxymelatonin Levels among Older Men

“…Men currently taking beta-blockers had lower pineal secretion capacity. This finding is in line with previous reports that men on beta-blockers have up to 50% reduction of melatonin production (Cowen et al, 1985; Rommel & Demisch, 1994). …”

Melatonin: therapeutic and clinical utilization

“…Synthesis and release of melatonin are stimulated by NE via beta1-adrenoceptors, and this process is further potentiated by stimulation of alpha1-adrenoceptors (77,78). Accordingly, beta-blockers have been shown to reduce the production of melatonin (79)(80)(81)(82)(83). Carvedilol is an effective adrenergic alpha1-and beta1-antagonist.…”

Sleep Disorders and Melatonin

“…Melatonin supplementation has theoretical benefi ts in the elderly due to agerelated reductions in melatonin secretion and in those individuals on beta-blockers, given the inhibitory role this medication may have on physiologic melatonin production [ 134 ]. Additionally, in several patient populations where sedative or other effects of benzodiazepines may be undesirable, melatonin has a role as a sleep aid.…”