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BMC Medicine
Published in: BMC Medicine 1/2018

Open Access 01-12-2018 | Research article

Melatonin and health: an umbrella review of health outcomes and biological mechanisms of action

Authors: Pawel P. Posadzki, Ram Bajpai, Bhone Myint Kyaw, Nicola J. Roberts, Amnon Brzezinski, George I. Christopoulos, Ushashree Divakar, Shweta Bajpai, Michael Soljak, Gerard Dunleavy, Krister Jarbrink, Ei Ei Khaing Nang, Chee Kiong Soh, Josip Car

Published in: BMC Medicine | Issue 1/2018

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Abstract

Background

Our aims were to evaluate critically the evidence from systematic reviews as well as narrative reviews of the effects of melatonin (MLT) on health and to identify the potential mechanisms of action involved.

Methods

An umbrella review of the evidence across systematic reviews and narrative reviews of endogenous and exogenous (supplementation) MLT was undertaken. The Oxman checklist for assessing the methodological quality of the included systematic reviews was utilised. The following databases were searched: MEDLINE, EMBASE, Web of Science, CENTRAL, PsycINFO and CINAHL. In addition, reference lists were screened. We included reviews of the effects of MLT on any type of health-related outcome measure.

Results

Altogether, 195 reviews met the inclusion criteria. Most were of low methodological quality (mean -4.5, standard deviation 6.7). Of those, 164 did not pool the data and were synthesised narratively (qualitatively) whereas the remaining 31 used meta-analytic techniques and were synthesised quantitatively. Seven meta-analyses were significant with P values less than 0.001 under the random-effects model. These pertained to sleep latency, pre-operative anxiety, prevention of agitation and risk of breast cancer.

Conclusions

There is an abundance of reviews evaluating the effects of exogenous and endogenous MLT on health. In general, MLT has been shown to be associated with a wide variety of health outcomes in clinically and methodologically heterogeneous populations. Many reviews stressed the need for more high-quality randomised clinical trials to reduce the existing uncertainties.
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Metadata
Title
Melatonin and health: an umbrella review of health outcomes and biological mechanisms of action
Authors
Pawel P. Posadzki
Ram Bajpai
Bhone Myint Kyaw
Nicola J. Roberts
Amnon Brzezinski
George I. Christopoulos
Ushashree Divakar
Shweta Bajpai
Michael Soljak
Gerard Dunleavy
Krister Jarbrink
Ei Ei Khaing Nang
Chee Kiong Soh
Josip Car
Publication date
01-12-2018
Publisher
BioMed Central
Published in
BMC Medicine / Issue 1/2018
Electronic ISSN: 1741-7015
DOI
https://doi.org/10.1186/s12916-017-1000-8

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