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Age and Ageing 2003; 32: 164-170
© 2003, British Geriatrics Society

Research Paper

Does melatonin improve sleep in older people? A randomised crossover trial

Jonathan J. Baskett1,, Joanna B. Broad2, Philip C. Wood3, John R. Duncan4, Megan J. Pledger4, Judie English5 and Josephine Arendt5

1 Home and Older Adults Services, Waitemata Health Ltd, Private Bag 93 503, Takapuna, Auckland, New Zealand
2 Department of Medicine and
3 University Geriatric Unit and
4 Clinical Trials Research Unit, School of Medicine, University of Auckland, Auckland, New Zealand
5 Centre for Chronobiology, Endocrinology and Metabolism Group, University of Surrey, Guildford, Surrey, UK

Abstract

Study objective: to determine whether melatonin will improve quality of sleep in healthy older people with age-related sleep maintenance problems.

Design: a double blind randomised placebo controlled crossover trial in healthy older volunteers.

Setting: a largely urban population, Auckland, New Zealand.

Participants: participants were part of the larger Possible Role of Melatonin in Sleep of Elders study. People 65 years or more of age were recruited through widespread advertising. We screened 414 potential participants by mail using the Pittsburgh Sleep Quality Index, and selected 194 for clinic interview. Exclusions included depression, cognitive impairment, hypnosedative medications, sleep phase abnormalities, medical and/or environmental problems that might impair sleep. Twenty normal and 20 problem sleepers were randomly allocated for this study from a larger sample of 60 normal and 60 problem sleepers.

Measurements and results: 24-hour urine 6-sulphatoxymelatonin was measured to estimate melatonin secretion in each participant. Five milligrams of melatonin, or matching placebo were each taken at bedtime for 4 weeks, separated by a 4-week washout period. Sleep quality was measured using sleep diaries, the Leeds Sleep Evaluation Questionnaire, and actigraphy. There was a significant difference between the groups in self-reported sleep quality indicators at entry, but no difference in melatonin secretion. Melatonin did not significantly improve any sleep parameter measured in either group.

Conclusion: 5 mg of fast release melatonin taken at bedtime does not improve the quality of sleep in older people with age-related sleep maintenance problems.

Keywords: melatonin, 6-sulphatoxymelatonin, sleep, elderly, older people


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