While melatonin does aid sleep in a certain group of people
whose biological clocks are out of kilter, researchers found
it doesn't promote sleep among the most common users of the
supplement -- those suffering from jet lag or weary shift
workers.
"A lot of people take melatonin for jet lag and shift work,
but we found no good evidence to justify the use of melatonin
in this context," said study author Dr. Terry Klassen, director
of the Evidence-Based Practice Center at the University of
Alberta in Edmonton, Canada.
The study, which was funded by the U.S. National Center
for Complementary and Alternative Medicine, was published
online by the Agency for Healthcare Research and Quality (AHRQ).
It is the most comprehensive look at the science behind the
claims that melatonin is a beneficial sleep aid, Klassen said.
"There has been a lot of emphasis on individual studies
rather than the overall picture, but when you put it all together,
it tells a more compelling story," he said.
The researchers found the quality of the studies varied,
with those that looked at the effects of melatonin on normal
sleepers generally of lower quality than those studies that
looked at people with sleep problems. Further, Klassen said,
all the studies tended to be small and of short duration,
with an average length of a few months, so that the long-term
effects of melatonin could not be assessed.
The authors also noted that in the studies assessing the
benefits of melatonin for normal sleepers, "there was considerable
evidence of possible publication bias in the selection of
the studies analyzed," they wrote. "We found a greater number
of studies reporting positive results compared to negative
results."
The one area where melatonin did seem to work was with a
group of people with a condition called "delayed sleep phase
syndrome," which means that otherwise healthy people have
a biological quirk that prevents a normal sleep cycle. For
these people, Klassen said, taking melatonin appeared to improve
their sleep.
"Melatonin helped to reset their biological clock," he said,
so that on average it reduced the time it took them to fall
asleep by about a half-hour.
Klassen said that although many people swear that melatonin
works for them when they're suffering from jet lag, the science
simply doesn't back up these claims.
"It could be a placebo effect, or the fact that sleep disorders
vary, and that someone would get better anyway," he said.
According to the National Institutes of Health, approximately
40 million Americans suffer from chronic, long-term sleep
disorders each year, and an additional 20 million experience
occasional sleeping problems. The most common sleep disorders
are insomnia, sleep apnea, restless leg syndrome (particularly
among elderly people), and narcolepsy, a condition in which
people suddenly fall asleep for short periods of time even
if they are well-rested.
Melatonin is a hormone found in the brain that helps the
body's sleeping and waking schedule. Typically, melatonin
levels rise in the evening, causing sleepiness, and are lower
in the morning to induce waking.
"When people go into stores, if a bottle of melatonin has
the word 'sleep' on it, there is an implied medical claim
that they're going to sleep better, and this report doesn't
support these implied benefits. It's a very good study," said
Dr. Meir Kryger, director of the Sleep Disorder Clinic at
St. Boniface Hospital Research Center at Winnipeg's University
of Manitoba in Canada and author of A Woman's Guide to
Sleep Disorders.
This is exactly why evidence-based studies are so important,
Klassen said.
"This is a huge issue, and an area where we should be spending
money to fund rigorous testing of these claims," he said.
"Sleep disorders can affect a person's quality of life and
job performance, which can translate into decreased productivity,
motor vehicle and industrial accidents, and even medical errors,"
AHRQ Director Dr. Carolyn M. Clancy said in a statement.
More information
Get tips on sleep aids from the National
Sleep Foundation.