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April 2013

Long-Term Effects of Melatonin Studied For Hemodialysis

Melatonin may have beneficial short-term effects on sleep in people undergoing hemodialysis, but long-term benefits may be lacking, a study reports.

Hemodialysis is a technique that is used to remove waste products from the body in people with kidney failure. Previous research suggests that sleep disturbances may be more common in these individuals than in the general population, due to the side effects of kidney disease and the dialysis treatment. Sleep disturbances may impact both general health and quality of life.

Studies have suggested that short-term melatonin supplementation may help improve sleep in people undergoing hemodialysis. Melatonin is a hormone produced in the brain by the pineal gland. The production and release of melatonin are stimulated by darkness and blocked by light, suggesting that melatonin may be involved in circadian rhythm and the regulation of various body functions. Levels of melatonin in the blood are highest prior to bedtime. Synthetic melatonin supplements have been used for a variety of medical conditions, most notably for disorders related to sleep.

In the current study, researchers set out to determine the effects of long-term melatonin supplementation on quality of life and sleep. They studied 67 people undergoing hemodialysis who reported having trouble sleeping. Participants were randomly assigned to receive three milligrams of melatonin or placebo daily for 12 months. The scientists evaluated the subjects' vitality and sleep improvement following supplementation.

Of the participants, 42 people completed the study. Effects on vitality were lacking in the melatonin group. At three months, sleep efficiency and sleep time both improved in those given melatonin, compared to the placebo group. However, at 12 months, significant differences in sleep quality were lacking between the two groups.

According to the research team, these results suggest that the positive effects of melatonin disappeared during study follow-up, and that vitality did not appear to improve. However, they emphasized that the high drop-out rate may have limited the strength of the findings. Further study is needed before firm conclusions can be made.

Many human studies have measured the effects of melatonin supplements on sleep in healthy individuals. A wide range of doses has been used, often taken by mouth 30-60 minutes prior to sleep time. Most trials have been small and brief in duration, and have not been rigorously designed or reported. However, the weight of scientific evidence does suggest that melatonin decreases sleep latency (the time it takes to fall asleep), increases the feeling of sleepiness, and may increase the duration of sleep. Better research is needed in this area.

Many integrative therapies have been studied for the treatment of sleep disorders in various populations. Caffeine is backed by strong scientific evidence for use in people suffering from apnea, while light therapy, music therapy, and tai chi are all supported by good scientific evidence for use in sleep disorders or general sleep quality. More research is needed.

For more information about melatonin, please visit Natural Standard's Foods, Herbs & Supplements Database.

References

  1. Natural Standard: The Authority on Integrative Medicine. 
  2. Russcher M, Koch BC, Nagtegaal JE, et al. Long-term effects of melatonin on quality of life and sleep in hemodialysis patients (Melody study): a randomized controlled trial. Br J Clin Pharmacol. 2013 Feb 21. doi: 10.1111/bcp.12093. [Epub ahead of print] 

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