Melatonin side effects in elderly
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Melatonin Side Effects in Elderly: A Comprehensive Review
Introduction to Melatonin and Its Use in Elderly
Melatonin, a hormone produced by the pineal gland, plays a crucial role in regulating the sleep-wake cycle. Its production often diminishes with age, leading to sleep disturbances among the elderly. This article synthesizes research findings on the side effects of melatonin use in older adults, focusing on its safety and efficacy.
Efficacy of Melatonin in Improving Sleep Quality
Sleep Efficiency and Quality
Several studies have demonstrated that melatonin significantly improves sleep quality in elderly individuals. For instance, a controlled-release formulation of melatonin was shown to enhance sleep efficiency and reduce wake time after sleep onset in elderly insomniacs1. Similarly, prolonged-release melatonin improved sleep quality and morning alertness in patients aged 55 and older, without causing withdrawal effects upon discontinuation2. These findings suggest that melatonin can be an effective treatment for sleep disturbances in the elderly.
Sleep Onset and Duration
Research indicates that melatonin can reduce sleep onset latency and increase total sleep duration. A meta-analysis revealed that melatonin treatment significantly reduced sleep onset latency by approximately 4 minutes and increased total sleep duration by about 13 minutes9. Additionally, high-dose melatonin (5 mg) was found to increase sleep efficiency during both nighttime and daytime sleep episodes in older adults10.
Side Effects and Safety Profile
Minor and Transient Side Effects
The majority of studies report that melatonin has a favorable safety profile with minimal side effects. Commonly reported adverse effects are minor and transient, such as pruritus, which resolved spontaneously1. In another study, no side effects or contraindications were reported during a 10-day trial of immediate-release melatonin in elderly individuals with mild cognitive impairment3.
Long-Term Safety Concerns
While short-term use of melatonin appears safe, there is limited evidence regarding the safety of prolonged use in older adults. A narrative review highlighted the need for more research to understand the long-term effects of melatonin on multiple organ systems, as its pleomorphic effects are not fully understood5.
Impact on Cardiovascular Health
Interestingly, melatonin may have beneficial effects beyond sleep regulation. A study on elderly individuals with hypertension found that daily melatonin administration reduced systolic and diastolic blood pressure, particularly during early morning hours when the risk of adverse cardiovascular events is highest6. This suggests that melatonin could have a protective effect on cardiovascular health in the elderly.
Conclusion
Melatonin is generally safe and effective for improving sleep quality in elderly individuals, with minimal and transient side effects. However, the long-term safety of melatonin use in this population remains unclear and warrants further investigation. Given its potential benefits, including improved cardiovascular health, melatonin could be a valuable treatment option for sleep disturbances in older adults.
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Most relevant research papers on this topic
Improvement of sleep quality in elderly people by controlled-release melatonin
Controlled-release melatonin effectively improves sleep quality in elderly people with insomnia, potentially due to melatonin deficiency.
RCT
Highly CitedProlonged‐release melatonin improves sleep quality and morning alertness in insomnia patients aged 55 years and older and has no withdrawal effects
Prolonged-release melatonin significantly improves sleep quality and morning alertness in insomnia patients aged 55 years and older, suggesting more restorative sleep without withdrawal symptoms.
RCTHighly CitedMelatonin effects on sleep, mood, and cognition in elderly with mild cognitive impairment
Melatonin can safely improve sleep quality, memory, and mood in elderly individuals with mild cognitive impairment when used short-term.
Non-RCTHighly CitedImpact of melatonin on toxicity and side effect after chemotherapy in elderly non-small cell lung cancer patients
Melatonin can reduce the toxicity and side effects of chemotherapy in elderly non-small cell lung cancer patients.
RCTCurrent Insights into the Risks of Using Melatonin as a Treatment for Sleep Disorders in Older Adults
Melatonin has a favorable safety profile for older adults with sleep disorders, but prolonged use is not well-studied and factors like age, obesity, and certain medications may increase the risk of adverse effects.
Literature ReviewDaily Melatonin Administration Attenuates Age-Dependent Disturbances of Cardiovascular Rhythms.
Daily melatonin administration can reduce blood pressure and improve circadian rhythm stability in elderly individuals, potentially improving their health and welfare.
RCT
Rigorous JournalPolysomnographic study of the effect of melatonin on sleep in elderly patients with chronic primary insomnia.
Melatonin effectively reduces wake time and increases total sleep time and sleep efficiency in elderly patients with chronic primary insomnia, without causing side effects.
Non-RCTHighly CitedMelatonin replacement therapy of elderly insomniacs.
Melatonin replacement therapy may improve sleep initiation and maintenance in melatonin-deficient elderly insomniacs.
RCTHighly CitedEffects of exogenous melatonin on sleep: a meta-analysis.
Exogenous melatonin significantly reduces sleep onset latency, increases sleep efficiency, and increases total sleep duration in healthy individuals.
Meta-AnalysisHighly CitedHigh dose melatonin increases sleep duration during nighttime and daytime sleep episodes in older adults
High dose melatonin (5 mg) significantly increases sleep duration and efficiency in older adults, potentially benefiting their health and quality of life.
RCT