Melatonin in primary insomnia: what is the evidence?

• Autor(a) principal: Costa, Rui Miguel
• Data de Publicação: 2016
• Outros Autores: Martins, Ivone dos Santos
• Tipo de documento: Artigo
• Idioma: por
• Título da fonte: Revista Brasileira de Medicina de Família e Comunidade (Online)
• Texto Completo: https://rbmfc.org.br/rbmfc/article/view/845
• topic: Melatonin; Sleep Initiation and Maintenance Disorders; Review; Melatonina; Trastornos del Inicio y del Mantenimiento del Sueño; Revisión; Melatonina Distúrbios do Início e da Manutenção do Sono - Revisão; Melatonina; Insónia Primária

Objectives: to review the existing evidence on the use of melatonin for relieving symptoms of primary insomnia and improving quality of life in patients ≥55 years of age. Methods: bibliographic search of the PubMed Database and evidence based medicine websites for meta-analyses, systematic reviews, randomized controlled trials (RCTs), and clinical guidelines published between March 2007 and January 2013 in English, Portuguese, or Spanish, using the MeSH terms “melatonin” and “sleep initiation and maintenance disorders”. The American Family Physician’s Strength of Recommendation (SOR) Taxonomy was used to establish the quality of the studies and define the strength of the recommendation. Results: of the 72 articles identified, six were selected: five RCTs and one clinical guideline. The RCTs reported that melatonin significantly improved quality of sleep, morning alertness, and quality of life compared with placebo. There was also a significant reduction in sleep latency. In these trials there were no withdrawal effects after discontinuation of treatment. The clinical guideline recommends the use of melatonin instead of a hypnotic in the treatment of insomnia in patients >55 years of age. Conclusion: there is sufficient evidence to recommend the use of melatonin for symptomatic relief of primary insomnia (SOR A), and improvement in quality of life (SOR B). However, further studies with rigorous methodologies and long-term monitoring are needed to obtain more consistent results.