The effectiveness of melatonin for promoting healthy sleep: a rapid evidence assessment of the literature.
A systematic review was conducted using Samueli Institute's Rapid Evidence Assessment of the Literature (REAL) process to determine the evidence base for melatonin as an agent to optimize sleep or improve sleep quality, and generalize the results to a military, civilian, or other healthy, active, adult population. Multiple databases were searched yielding 35 randomized controlled trials (RCTs) meeting the review's inclusion criteria, which were assessed for methodological quality as well as for melatonin effectiveness. The majority of included studies were high quality (83.0%). Overall, according to Grading Recommendations, Assessment Development and Evaluation (GRADE) methodology, weak recommendations were made for preventing phase shifts from jet lag, for improving insomnia in both healthy volunteers and individuals with a history of insomnia, and for initiating sleep and/or improving sleep efficacy. Based on the literature to date, no recommendations for use in shift workers or to improve hormonal phase shift changes in healthy people can be made at this time. Larger and longer-duration RCTs utilizing well characterized products are needed to warrant melatonin recommendations in young, healthy adults.
Rebecca B
RB
Costello
Cynthia V
CV
Lentino
Courtney C
CC
Boyd
Meghan L
ML
O'Connell
Cindy C
CC
Crawford
Meredith L
ML
Sprengel
Uniformed Services University of the Health Sciences, Department of Military and Emergency Medicine, 4301 Jones Bridge Road, Bethesda, MD 20814-4799, USA. patricia.deuster@usuhs.edu.
Patricia A
PA
Deuster
D019317:Evidence-Based Medicine; D006293:Health Promotion; D006801:Humans; D008550:Melatonin / Q000494:pharmacology*; D016032:Randomized Controlled Trials as Topic; D012890:Sleep / Q000187:drug effects*
D008550:Melatonin