Servicio de Neurología, Hospital Universitario Donostia, San Sebastián, Spain.
Unidad Multidisciplinar de Sueño, Hospital Universitario de Santa María, Lleida, Spain.
Neurologia (Engl Ed). 2022 Sep;37(7):575-585. doi: 10.1016/j.nrleng.2018.08.004. Epub 2020 Sep 18.
Melatonin is the main hormone involved in the control of the sleep-wake cycle. It is easily synthesisable and can be administered orally, which has led to interest in its use as a treatment for insomnia. Moreover, as production of the hormone decreases with age, in inverse correlation with the frequency of poor sleep quality, it has been suggested that melatonin deficit is at least partly responsible for sleep disorders. Treating this age-related deficit would therefore appear to be a natural way of restoring sleep quality, which is lost as patients age. However, despite the undeniable theoretical appeal of this approach to insomnia, little scientific evidence is available that supports any benefit of this substitutive therapy. Furthermore, the most suitable dose ranges and pharmaceutical preparations for melatonin administration are yet to be clearly defined. This review addresses the physiology of melatonin, the different pharmaceutical preparations, and data on its clinical usefulness.
褪黑素是控制睡眠-觉醒周期的主要激素。它很容易合成，可以口服给药，这使得人们对其作为失眠治疗药物产生了兴趣。此外，由于随着年龄的增长，激素的产生减少，与睡眠质量差的频率呈反比，因此有人认为褪黑素缺乏至少部分是导致睡眠障碍的原因。因此，治疗这种与年龄相关的缺乏症似乎是一种恢复睡眠质量的自然方法，因为随着患者年龄的增长，睡眠质量会下降。然而，尽管这种治疗失眠的方法在理论上具有不可否认的吸引力，但几乎没有科学证据支持这种替代疗法的任何益处。此外，褪黑素给药的最合适剂量范围和药物制剂尚未明确界定。本文综述了褪黑素的生理学、不同的药物制剂以及其临床应用的数据。
