Melatonin as a Chronobiotic Intervention for Advancing Sleep Timing and Enhancing Sleep Quality in Delayed Sleep-Wake Phase Disorder: A Systematic Review and Meta-Analysis on Randomized Controlled Trials Studies
Abstract
Background and Objective Delayed Sleep-Wake Phase Disorder (DSWPD) is a sleep disorder that causes difficulty falling asleep, leading to functional impairment in daily activities. This review study analyzes the effectiveness of exogenous melatonin through the optimal timing of melatonin administration and standard dosage on improving sleep quality and shifting the sleep chronobiology of DSWPD patients.Methods Based on the guidelines from Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020, literature review searches were conducted using databases such as PubMed, Scopus, Web of Science, and Proquest. Methodological quality assessment was performed using Cochrane Risk of Bias 2.0 and the overall analysis was conducted using R 5.4.2 to process the data.Results Overall analysis of actigraphy shows that exogenous melatonin improves sleep quality, such as wakefulness after sleep onset and sleep onset latency (SOL) (z=-4.94, p<0.0001), total sleep time (TST) and time in bed (TIB) (z=3.72, p=0.0002), and shifts sleep timing (z=-8.80, p<0.0001) such as dim light melatonin onset (DLMO), sleep onset time, sleep offset time, and wake-up time. Subgroup analysis indicated that high-dose exogenous melatonin (≥3 mg) reduced SOL parameters (z=-4.11, p<0.0001), while low-dose exogenous melatonin (<3 mg) significantly increased TST parameters (z=6.52, p<0.0001). Meta-regression on melatonin administration 3–5 hours before DLMO was found to be effective (SOL parameter result…
How strong is the evidence?
Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid.
Read the paper
Related studies
- Tryptophan Metabolism and Gut-Brain Homeostasis
- Rationale for a Multi-Factorial Approach for the Reversal of Cognitive Decline in Alzheimer’s Disease and MCI: A Review
- Prioritized Research for the Prevention, Treatment, and Reversal of Chronic Disease: Recommendations From the Lifestyle Medicine Research Summit
- Relationship between sleep disorders and gut dysbiosis: what affects what?
- The role of CLOCK gene in psychiatric disorders: Evidence from human and animal research
- Genetic, Transcriptome, Proteomic, and Epidemiological Evidence for Blood-Brain Barrier Disruption and Polymicrobial Brain Invasion as Determinant Factors in Alzheimer’s Disease
Go deeper in Evidence Hub
Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.