Study Finds How to Make Melatonin Most Effective

PORTLAND, Ore.--A study in Oct. 12's The New England Journal of Medicine (NEJM) (343:1070-1077, 2000) found that people who were completely blind with skewed circadian rhythms experienced "normal" sleep patterns while taking melatonin.

Most blind people have circadian rhythms (a cycle within a 24-hour span) that are "free-running," meaning they are not synchronized to environmental time cues and that encompass a cycle slightly longer than a 24-hour day. This condition, according to researchers at Oregon Health Sciences University, can cause recurrent insomnia and daytime drowsiness.

In a crossover, placebo-controlled study, seven blind subjects with free-running circadian rhythms were given 10 mg of melatonin daily, for three to nine weeks, with instructions to take the supplement one hour before bedtime. The production of endogenous melatonin was measured in order to mark the individual's circadian cycle. Sleep was monitored by polysomnography.

At the beginning of the study, subjects had circadian cycles averaging 24.5 hours. When using placebo, no change in cycles was noted. When using melatonin, six out of seven participants were entrained to a 24.0-hour cycle; also, melatonin supplementation induced subjects to sleep more quickly and achieve a better sleep. Three study participants reduced melatonin to 0.5 mg per day over a period of three months and continued to experience this new cycle and quality of sleep.

This study may offer a new insight into the efficacy of melatonin supplementation. In an editorial in the same issue of NEJM, Dr. Josephine Arendt from the University of Surrey in England, stated that ".the importance of the timing of treatment is becoming clear. Our 24-hour society, with its chaotic time cues and lack of natural light, may yet reap substantial benefits." Arendt also wrote that another noteworthy point was that .5 mg per day of melatonin could maintain this new sleep pattern. However, she suggested that further research should be done on the safety of consuming low doses of melatonin for a long period of time.

For additional information, visit www.nejm.com.

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