Clinical Interventions in Aging (Jan 2023)
Current Insights into the Risks of Using Melatonin as a Treatment for Sleep Disorders in Older Adults
Abstract
Colin Tuft,1 Elie Matar,2 Zoe Menczel Schrire,2 Ronald R Grunstein,2,3 Brendon J Yee,1– 3 Camilla M Hoyos2,4 1Department of Respiratory and Sleep Medicine, Royal Prince Alfred Hospital, Sydney, NSW, Australia; 2Centre for Sleep and Chronobiology, Woolcock Institute of Medical Research, Sydney Medical School, Sydney, NSW, Australia; 3Central Clinical School, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia; 4School of Psychology, Faculty of Science, The University of Sydney, Sydney, NSW, AustraliaCorrespondence: Camilla M Hoyos, Centre for Sleep and Chronobiology, Woolcock Institute of Medical Research, Sydney Medical School, Sydney, NSW, Australia, Tel +61 2 9114 0409, Email [email protected]: Exogenous melatonin is commonly used for sleep disorders in older adults, and its use is increasing over time. It appears to have modest efficacy in treating insomnia and circadian rhythm sleep-wake disorders. Melatonin is commonly perceived to be a safe alternative to other hypnotics and is available without prescription in some jurisdictions. New evidence suggests that endogenous melatonin has pleomorphic effects on multiple organ systems, many of which are poorly understood. This narrative review summarizes the current evidence regarding the safety of melatonin in older adults (defined by age over 65 years). Melatonin appears to have a favorable safety profile in this population, however there is a dearth of evidence regarding the safety of prolonged use. There are several factors which increase the risk of adverse effects of melatonin in older adults, and these should be taken into consideration when prescribing to this population.Keywords: adverse effect, safety, insomnia, elderly, sleep wake phase disorder
