Melatonin as a Chronobiotic: Treatment of Circadian Desynchrony in Night Workers and the Blind

Robert Sack, Alfred Lewy

Research output: Contribution to journalArticle

84 Citations (Scopus)

Abstract

Although the causes are different, totally blind people (without light perception) and night shift workers have in common recurrent bouts of insomnia and wake-time sleepiness that occur when their preferred (or mandated) sleep and wake times are out of synchrony with their endogenous circadian rhythms. In this article, the patterns of circadian desynchrony in these two populations are briefly reviewed with special emphasis on longitudinal studies in individual subjects that used the timing of melatonin secretion as a circadian marker. In totally blind people, the most commonly observed pattern is a free-running rhythm with a stable non-24-h circadian period (24.2-24.5 h), although some subjectively blind people are normally entrained, perhaps by residually intact retinoypothalamic photic pathways. Experiments at the cellular and behavioral levels have shown that melatonin can produce time dependent circadian phase shifts. With this in mind, melatonin has been administered to blind people in an attempt to entrain abnormal circadian rhythms, and substantial phase shifts have been accomplished; however, it remains to be demonstrated unequivocally that normal long-term entrainment can be produced. In untreated night shift workers, the degree and direction of phase shifting in response to an inverted sleep-wake schedule appears to be quite variable. When given at the optimal circadian time, melatonin treatment appears to facilitate phase shifting in the desired direction. Melatonin given prior to a night worker's daytime sleep also may attenuate interference from the circadian alerting process. Because melatonin has both phase-shifting and sleep-promoting actions, night shift workers, who number in the millions, may be the most likely group to benefit from treatment.

Original languageEnglish (US)
Pages (from-to)595-603
Number of pages9
JournalJournal of Biological Rhythms
Volume12
Issue number6
StatePublished - Dec 1997

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melatonin
Melatonin
sleep
Sleep
Circadian Rhythm
circadian rhythm
Therapeutics
Sleep Initiation and Maintenance Disorders
longitudinal studies
Longitudinal Studies
Appointments and Schedules
secretion
Light
Population

Keywords

  • Blindness
  • Circadian rhythms
  • Insomnia
  • Melatonin
  • Shift work
  • Sleep disorders

ASJC Scopus subject areas

  • Agricultural and Biological Sciences (miscellaneous)
  • Physiology
  • Physiology (medical)

Cite this

Melatonin as a Chronobiotic : Treatment of Circadian Desynchrony in Night Workers and the Blind. / Sack, Robert; Lewy, Alfred.

In: Journal of Biological Rhythms, Vol. 12, No. 6, 12.1997, p. 595-603.

Research output: Contribution to journalArticle

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