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CNS Drugs
Published in: CNS Drugs 12/2007

01-12-2007 | Review Article

Role of the Melatonin System in the Control of Sleep

Therapeutic Implications

Authors: Dr Seithikurippu R. Pandi-Perumal, Venkatramanujan Srinivasan, D. Warren Spence, Daniel P. Cardinali

Published in: CNS Drugs | Issue 12/2007

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Abstract

The circadian rhythm of pineal melatonin secretion, which is controlled by the suprachiasmatic nucleus (SCN), is reflective of mechanisms that are involved in the control of the sleep/wake cycle. Melatonin can influence sleep-promoting and sleep/wake rhythm-regulating actions through the specific activation of MT1 (melatonin la) and MT2 (melatonin 1b) receptors, the two major melatonin receptor subtypes found in mammals. Both receptors are highly concentrated in the SCN. In diurnal animals, exogenous melatonin induces sleep over a wide range of doses. In healthy humans, melatonin also induces sleep, although its maximum hypnotic effectiveness, as shown by studies of the timing of dose administration, is influenced by the circadian phase.
In both young and elderly individuals with primary insomnia, nocturnal plasma melatonin levels tend to be lower than those in healthy controls. There are data indicating that, in affected individuals, melatonin therapy may be beneficial for ameliorating insomnia symptoms. Melatonin has been successfully used to treat insomnia in children with attention-deficit hyperactivity disorder or autism, as well as in other neurodevelopmental disorders in which sleep disturbance is commonly reported.
In circadian rhythm sleep disorders, such as delayed sleep-phase syndrome, melatonin can significantly advance the phase of the sleep/wake rhythm. Similarly, among shift workers or individuals experiencing jet lag, melatonin is beneficial for promoting adjustment to work schedules and improving sleep quality.
The hypnotic and rhythm-regulating properties of melatonin and its agonists (ramelteon, agomelatine) make them an important addition to the armamentarium of drugs for treating primary and secondary insomnia and circadian rhythm sleep disorders.
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Metadata
Title
Role of the Melatonin System in the Control of Sleep
Therapeutic Implications
Authors
Dr Seithikurippu R. Pandi-Perumal
Venkatramanujan Srinivasan
D. Warren Spence
Daniel P. Cardinali
Publication date
01-12-2007
Publisher
Springer International Publishing
Published in
CNS Drugs / Issue 12/2007
Print ISSN: 1172-7047
Electronic ISSN: 1179-1934
DOI
https://doi.org/10.2165/00023210-200721120-00004

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