This site is intended for healthcare professionals

Go to /sign-in page

You can view 5 more pages without signing in

Melatonin in adult insomnia

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

Melatonin is the primary regulatory hormone of the circadian rhythm in humans

  • is secreted by the pineal gland and synthesized from serotonin, which originates from tryptophan, a natural mild sedative
  • peaks in low light and is suppressed by daylight
  • the onset of its secretion positively correlates with sleepiness
  • peak nocturnal melatonin concentrations decline with age, and delayed peaks are associated with sleep disorders in older adults (1)
  • due to its role in regulating the circadian rhythm, melatonin has been used to prevent delirium in older hospitalized patients (1)
  • a controlled-release formulation of melatonin (Circadin® 2 mg) was first approved by the European Medicines Agency (EMA) as a monotherapy for the short-term treatment of primary insomnia in elderly patients aged over 55 years (2)
  • in the UK melatonin is licensed for short-term use in the management of insomnia (3):
    • for adults 55 years and over
      • 2 mg once daily for up to 13 weeks, dose to be taken 1-2 hours before bedtime
    • Jet lag [short-term use] for melatonin
      • by mouth using immediate-release medicines
      • Adult
        • 3 mg once daily for up to 5 days, the first dose should be taken at the habitual bedtime after arrival at destination
        • doses should not be taken before 8 p.m. or after 4 a.m, dose may be increased to 5 or 6 mg once daily if necessary, or reduced to 1 or 2 mg once daily if sufficient
        • maximum of 16 treatment courses per year

Check the respective Summary of Product Characteristics (SPC) before prescribing melatonin.

Notes:

  • Circadin® is licensed for the short-term treatment of primary insomnia in adults aged 55 years and over, and some immediate-release formulations, such as Adaflex®, Ceyesto®, and Syncrodin®, are licensed for the short-term treatment of jet lag in adults

Reference:

  1. Salahub C, Wu PE, Burry LD, Soong C, Sheehan KA, MacMillan TE, Lapointe-Shaw L. Melatonin for Insomnia in Medical Inpatients: A Narrative Review. J Clin Med. 2022 Dec 29;12(1):256.
  2. Kim HK, Yang KI. Melatonin and melatonergic drugs in sleep disorders. Transl Clin Pharmacol. 2022 Dec;30(4):163-171
  3. NICE - British National Formulary (BNF). Melatonin (accessed 8/5/2024)

Create an account to add page annotations

Annotations allow you to add information to this page that would be handy to have on hand during a consultation. E.g. a website or number. This information will always show when you visit this page.

The content herein is provided for informational purposes and does not replace the need to apply professional clinical judgement when diagnosing or treating any medical condition. A licensed medical practitioner should be consulted for diagnosis and treatment of any and all medical conditions.

Connect

Copyright 2024 Oxbridge Solutions Limited, a subsidiary of OmniaMed Communications Limited. All rights reserved. Any distribution or duplication of the information contained herein is strictly prohibited. Oxbridge Solutions receives funding from advertising but maintains editorial independence.