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CNS Drugs

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01.12.2007 | Review Article

Role of the Melatonin System in the Control of Sleep

Therapeutic Implications

verfasst von: Dr Seithikurippu R. Pandi-Perumal, Venkatramanujan Srinivasan, D. Warren Spence, Daniel P. Cardinali

Erschienen in: CNS Drugs | Ausgabe 12/2007

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Abstract

The circadian rhythm of pineal melatonin secretion, which is controlled by the suprachiasmatic nucleus (SCN), is reflective of mechanisms that are involved in the control of the sleep/wake cycle. Melatonin can influence sleep-promoting and sleep/wake rhythm-regulating actions through the specific activation of MT₁ (melatonin la) and MT₂ (melatonin 1b) receptors, the two major melatonin receptor subtypes found in mammals. Both receptors are highly concentrated in the SCN. In diurnal animals, exogenous melatonin induces sleep over a wide range of doses. In healthy humans, melatonin also induces sleep, although its maximum hypnotic effectiveness, as shown by studies of the timing of dose administration, is influenced by the circadian phase.

In both young and elderly individuals with primary insomnia, nocturnal plasma melatonin levels tend to be lower than those in healthy controls. There are data indicating that, in affected individuals, melatonin therapy may be beneficial for ameliorating insomnia symptoms. Melatonin has been successfully used to treat insomnia in children with attention-deficit hyperactivity disorder or autism, as well as in other neurodevelopmental disorders in which sleep disturbance is commonly reported.

In circadian rhythm sleep disorders, such as delayed sleep-phase syndrome, melatonin can significantly advance the phase of the sleep/wake rhythm. Similarly, among shift workers or individuals experiencing jet lag, melatonin is beneficial for promoting adjustment to work schedules and improving sleep quality.

The hypnotic and rhythm-regulating properties of melatonin and its agonists (ramelteon, agomelatine) make them an important addition to the armamentarium of drugs for treating primary and secondary insomnia and circadian rhythm sleep disorders.

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Titel: Role of the Melatonin System in the Control of Sleep
Therapeutic Implications
verfasst von: Dr Seithikurippu R. Pandi-Perumal
Venkatramanujan Srinivasan
D. Warren Spence
Daniel P. Cardinali
Publikationsdatum: 01.12.2007
Verlag: Springer International Publishing
Erschienen in: CNS Drugs / Ausgabe 12/2007
Print ISSN: 1172-7047
Elektronische ISSN: 1179-1934
DOI: https://doi.org/10.2165/00023210-200721120-00004

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Acknowledgement