Optimal Melatonin Dose in Older Adults: A Clinical Review of the Literature
Optimal Melatonin Dose in Older Adults: A Clinical Review of the Literature
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DOI：
10.4140/tcp.n.2019.419
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发表时间：
2019-07-01
影响因子：
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通讯作者：
Fixen, Danielle R.
中科院分区：
文献类型：
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作者：
Pierce, Mackenzie;Linnebur, Sunny A.;Fixen, Danielle R.
目的：回顾评估褪黑激素剂量及其对 65 岁及以上成人睡眠影响的临床研究。 数据来源：使用以下医学主题词检索 MEDLINE 数据库（1946 年至 2018 年 10 月 10 日）：褪黑激素和：睡眠启动和维持障碍、睡眠障碍、睡眠觉醒障碍、失眠、内在睡眠障碍和昼夜节律睡眠障碍。来源仅限于英语和人类数据。 研究选择/数据提取：初步检索得出 144 篇出版物，其中 25 篇纳入本综述。根据设计、参与者的平均年龄、外源性褪黑激素的使用以及任何睡眠相关结果的报告，选择研究进行全面审查。 数据综合：由于大多数处方和非处方助眠剂的副作用，安全有效的替代疗法是必要的。根据目前的文献，尚未发现褪黑激素对老年人睡眠改善的剂量相关反应。褪黑激素配方和剂量的差异，以及测量睡眠结果的可用工具，使得比较研究变得具有挑战性。结论：本综述评估了各种褪黑激素剂量（0.5 毫克至 10 毫克）及其对老年人睡眠的影响。结果各不相同，一些研究发现与安慰剂相比，睡眠结果没有差异，而其他研究则发现睡眠结果具有统计学上的显着改善。 1 毫克至 6 毫克剂量的褪黑激素似乎可有效改善老年人的睡眠；然而，需要进一步研究来找到最佳的最小有效剂量。
OBJECTIVE: To review clinical studies evaluating melatonin doses and their effects on sleep in adults 65 years of age and older.DATA SOURCES: The MEDLINE databases were searched (1946 to October 10, 2018) using the following Medical Subject Heading terms: melatonin and: sleep initiation and maintenance disorders, dyssomnia, sleep wake disorders, insomnia, sleep disorders intrinsic, and sleep disorders circadian rhythm. Sources were limited to English and human data.STUDY SELECTION/DATA EXTRACTION: An initial search resulted in 144 publications, with 25 included in this review. Studies were selected for full review based on design, mean age of participants, use of exogenous melatonin, and reports on any sleep-related outcome.DATA SYNTHESIS: Because of the side effect profiles of most prescription and nonprescription sleep aids, safe and effective alternative therapies are necessary. Based on the current literature, no dose-related response to sleep improvement has been identified for melatonin in older adults. Variations in melatonin formulation and dosages, as well as available tools to measure sleep outcomes, make it challenging to compare studies.CONCLUSIONS: This review evaluated a variety of melatonin doses, 0.5 mg to 10 mg, and their effects on sleep in older adults. The results varied, with some studies finding no difference in sleep outcomes when compared with placebo, while other studies found statistically significant improvements in sleep outcomes. Doses of melatonin between 1 mg and 6 mg appear to be effective for improving sleep in older adults; however, further studies are needed to find the optimal minimum effective dose.