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Melatonin Rhythm Abnormalities and Sleep Disorders in the Elderly

Published online by Cambridge University Press:  07 November 2014

Abstract

Biological aging is often associated with sleep problems and daytime napping. Complaints of difficulty in initiating and maintaining sleep, as well as daytime drowsiness, are more common in the elderly than in any other age group. This report reviews evidence that impaired melatonin secretion is associated with sleep disorders in old age. Circulating melatonin levels have been found to be significantly lower and onset and peak times have been delayed in elderly insomniacs as compared to age-matched control subjects. In view of these findings, we investigated the effects of melatonin treatment on melatonin-deficient insomnia in the elderly. From the results of our study, it seems likely that melatonin replacement therapy may be beneficial in the initiation and maintenance of sleep in this population.

Type
Feature Articles
Copyright
Copyright © Cambridge University Press 2001

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References

REFERENCES

1.Miles, LE, Dement, WC. Sleep and aging. Sleep. 1980;3:119220.Google ScholarPubMed
2.Fowies, DG. A Profile of the Americans, 1988. Washington, DC: American Association of Retired Persons; 1989.Google Scholar
3.Ford, DE, Kameron, DB. Epidemiologic study of sleep disturbances and psychiatric disorders: an opportunity for prevention? JAMA. 1989;262:14791488.CrossRefGoogle ScholarPubMed
4.Dement, WC, Miles, LE, Carskadon, MA. White paper on sleep and aging. J Am Geriatr Soc. 1982;30:2550.CrossRefGoogle ScholarPubMed
5.Moran, MG, Thompson, TL, Nies, AS. Sleep disorders in the elderly. Am J Psychiatry. 1988;145:13691378.Google ScholarPubMed
6.Prinz, PN, Vitiello, MV, Roskind, MA, et al.Geriatrics: sleep disorders and aging. N Engl J Med. 1990;23:520526.Google Scholar
7.Monk, TH, Reynold, CF, Buysse, DJ, et al.Circadian characteristics of healthy 80-year-olds and their relationship to objectively recorded sleep. J Gerontol. 1991;46:M171M175.CrossRefGoogle ScholarPubMed
8.Buysse, DJ, Browman, KE, Monk, TH, et al.Napping and 24-hour sleep/wake patterns in healthy elderly and young adults. J Am Geriatr Soc. 1992;40:779786.CrossRefGoogle ScholarPubMed
9.Jacobs, D, Ancoli-Israel, S, Parker, L, Kripke, DF. 24-hour sleep-wake patterns in a nursing home population. Psychol Aging. 1989;4:352356.CrossRefGoogle Scholar
10.Regestein, QR, Morris, J. Daily sleep patterns observed among institutionalized elderly residents. J Am Geriatr Soc. 1987;35:767772.CrossRefGoogle ScholarPubMed
11.Bixler, ED, Vela-Bueno, A. Normal sleep, physiological, behavioral and clinical correlates. Psychiatr Ann. 1987;17:437445.CrossRefGoogle Scholar
12.Feinberg, I, Kovesko, R, Heller, N. EEG sleep patterns as a function of normal and pathological aging in man. J Psychiatry Res. 1967;5:107144.CrossRefGoogle ScholarPubMed
13.Reynolds, CF, Kupfer, DJ, Taska, LS, et al.EEG sleep in elderly depressed, demented and healthy subjects. Biol Psychiatry. 1985;20:431442.CrossRefGoogle ScholarPubMed
14.Kripke, DF, Simons, RN, Garfinkle, I, et al.Short and long sleep and sleeping pills. Arch Gen Psychiatry. 1979;36:103116.CrossRefGoogle Scholar
15.Lynch, HJ, Wurtman, RJ, Moskowitz, MA, Archer, MC, Ho, MH. Daily rhythm in human urinary melatonin. Science. 1975;187:169171.CrossRefGoogle ScholarPubMed
16.Utinger, RD. Melatonin—the hormone of darkness. N Eng J Med. 1992;327:13771379.CrossRefGoogle Scholar
17.Arendt, J. Melatonin and The Mammalian Pineal Gland. London, England: Chapman & Hall; 1995.Google Scholar
18.Reppert, SM, Weaver, DR, Ebisawa, T. Cloning and characterization of a mammalian melatonin receptor that mediated reproductive and circadian responses. Neuron. 1994;13:11771185.CrossRefGoogle ScholarPubMed
19.Dubocovich, ML. Melatonin receptors: are there multiple subtypes? Trends Pharmacol Sci. 1995;16:5056.CrossRefGoogle ScholarPubMed
20.Anton-Tay, F, Diaz, JL, Fernandez-Guardiola, M. On the effects of melatonin upon human brain: its possible therapeutic implications, Life Sci. 1971;10:841850.CrossRefGoogle ScholarPubMed
21.Vollrath, L, Semm, P, Gammel, G. Sleep induction by internasal application of melatonin. Adv Biosci. 1981;29:327329.Google Scholar
22.Arendt, JM, Borbely, AA, Franey, C, Wright, J. The effects of chronic, small doses of melatonin given in the late afternoon on fatigue in man: a preliminary study. Neurosci Lett. 1984;45:317321.CrossRefGoogle ScholarPubMed
23.Lieberman, HR, Waldhauser, F, Garfield, G, Lynch, HJ, Wurtman, RJ. Effects of melatonin on human mood and performance. Brain Res. 1984;323:201207.CrossRefGoogle ScholarPubMed
24.MacFarlane, JG, Cleghorn, JM, Brown, GM, Streiner, DL. The effects of exogenous melatonin on the total sleep time and daytime alertness of chronic insomniacs: a preliminary study. Biol Psychol. 1991;30:371376.CrossRefGoogle ScholarPubMed
25.James, SP, Mendelson, WB, Sack, DA, Rosenthal, NE, Wehr, TA. The effects of melatonin on normal sleep. Neuropsychopharmacol. 1987;1:4144.CrossRefGoogle ScholarPubMed
26.James, SP, Sack, D, Rosenthal, N, Mendelson, W. Melatonin administration in insomnia. Neuropsychopharmacol. 1990;3:1923.Google ScholarPubMed
27.Shochat, T, Haimov, I, Lavie, P. Melatonin—the key to the gate of sleep. Ann Med. 1998;30:109114.Google Scholar
28.Lewy, AJ, Sack, PL. The dim light melatonin onset as a marker for circadian phase position. Chronobiol Int. 1989;6:93102.CrossRefGoogle ScholarPubMed
29.Arendt, J, Aldhous, M, English, J, et al.The effects of jetlag and their alleviation by melatonin. Ergonomics. 1987;30:13791393.CrossRefGoogle Scholar
30.Tzischinsky, O, Pal, I, Epstein, R, Dagan, Y, et al.The importance of timing in melatonin administration in a blind man. J Pineal Res. 1992;12:105108.CrossRefGoogle Scholar
31.Sack, RL, Lewy, AJ, Blood, ML, et al.Melatonin administration to blind people: phase advances and entrainment. J Biol Rhythms. 1991;6:249261.CrossRefGoogle ScholarPubMed
32.Cagnacci, A, Soldani, R, Romagnolo, C, Yen, SSC. Melatonin induced decrease of body temperature in women: a threshold event. J Neuroendocrinol. 1994;60:549552.CrossRefGoogle ScholarPubMed
33.Dimenas, E, Kerr, D, Macdonald, I. Beta-adrenoceptor blockade and CNS-related symptoms: a randomized, double-blind, placebo-controlled comparison of metaprolol CR/ZOK, atenolol and propanolol LA in healthy subjects. J Clin Pharmacol. 1990;30:S103S107.CrossRefGoogle Scholar
34.Brismar, K, Hylander, B, Eliasson, K, et al.Melatonin secretion related to side-effects of beta-blockers from the central nervous system. Acta Med Scand. 1988;223:525530.CrossRefGoogle ScholarPubMed
35.Lewy, AJ, Wehr, TA, Goodwin, FK, et al.Light suppresses melatonin secretion in humans. Science. 1980;210:12671269.CrossRefGoogle ScholarPubMed
36.Badia, P, Myers, B, Boecker, M, et al.Bright light effects on body temperature, alertness, EEG, and behavior. Physiol Behav. 1991;50:583588.CrossRefGoogle ScholarPubMed
37.Campbell, SS, Dawson, D. Enhancement of nighttime alertness and performance with bright ambient light. Physiol Behav. 1990;48:317320.CrossRefGoogle ScholarPubMed
38.Sack, RL, Blood, ML, Ormerod, GM, et al.Oral melatonin reverses the alerting effects of nocturnal bright light exposure in human. J Sleep Res. 1992;21:49.Google Scholar
39.Touitou, Y, Fevre, M, Lagoguey, M, et al.Age- and mental health-related circadian rhythms of plasma levels of melatonin, prolactin, luteinizing hormone and follicle-stimulating hormone in man. J Endocrinol. 1981;91:467475.CrossRefGoogle ScholarPubMed
40.Sharma, M, Palacios-Bois, J, Schwartz, G, et al.Circadian rhythms of melatonin and cortisol in aging. Biol Psychiatry. 1989;25:305319.CrossRefGoogle ScholarPubMed
41.Haimov, I, Laudon, M, Zisapel, N, et al.Impaired 6-sulfatoxymelatonin rhythms in the elderly: coincidence with sleep disorders. Br Med J. 1994;309:167.CrossRefGoogle Scholar
42.Youngstedt, SD, Kripke, DF, Elliott, JA. Melatonin excretion is not related to sleep in the elderly. J Pineal Res. 1998;24:142145.CrossRefGoogle Scholar
43.Lushington, K, Dawson, D, Kennaway, DJ, Lack, L. The relationship between 6-sulphatoxymelatonin and polysomnographic sleep in good sleeping controls and wake maintenance insomniacs, aged between 50-80 years. J Sleep Res. 1999;8:5764.CrossRefGoogle Scholar
44.Akerstedt, T, Gillberg, M. Experimentally displaced sleep: effects on sleepiness. Electroencephalogr Clin Neurophysiol. 1982;54:220226.CrossRefGoogle ScholarPubMed
45.Aldhous, M, Franey, C, Wright, J, Arendt, J. Plasma concentrations of melatonin in man following oral absorption of different preparations. Br J Clin Pharmac. 1985;19:517521.CrossRefGoogle ScholarPubMed
46.Haimov, I, Lavie, P, Laudon, M, et al.Melatonin replacement therapy of elderly insomniacs. Sleep. 1995;18:598603.CrossRefGoogle ScholarPubMed
47.Garfinkel, D, Laudon, M, Nof, D, Zisapel, N. Improvement of sleep quality in elderly people by controlled-release melatonin. Lancet. 1995;346:541544.CrossRefGoogle ScholarPubMed
48.Hughes, RJ, Sack, RI, Lewy, AJ. The role of melatonin and circadian phase in age-related sleep-maintenance insomnia: assessment in a clinical trail of melatonin replacement. Sleep. 1998;21:5268.Google Scholar
49.Fainstein, I, Bonetto, AJ, Brusco, LI, Cardinali, DP. Effects of melatonin in elderly patients with sleep disturbance: a pilot study. Therapeutic Research. 1997;58:9901000.CrossRefGoogle Scholar
50.Monti, JM, Alvarino, F, Cardinali, D, Savio, I, Pintos, A. Polysomnographic study of the effect of melatonin on sleep in elderly patients with chronic primary insomnia. Arch Gerontol Geriatr. 1999;28:8598.CrossRefGoogle ScholarPubMed