Melatonin administration for sleep disorders in traumatic brain injury: A review of the literature

Abstract

Melatonin is a neurohormone that acts at the suprachiasmatic nucleus to diminish the wake-promoting signal of the circadian clock and induce sleepiness. Exogenous melatonin is available as an over-the-counter supplement to induce sleepiness with 1.3% of adults reporting melatonin use in the past 30 days in 2012. Melatonin is also a frequently used treatment for sleep disturbances in the traumatic brain injury (TBI) population, however, evidence of melatonin efficacy for disordered sleep in this population is scarce. This article reviews the evidence regarding melatonin or melatonin receptor agonists used for sleep disorders in the TBI population. A literature search was performed using PubMed, Embase, Ovid MEDLINE, Cochrane Library, and Google Scholar. In total, four clinical randomized controlled trials were summarized and graded based on the American Academy of Neurology clinical practice guidelines. The evidence that exists suggests melatonin or melatonin receptor agonists improve some aspects of sleep in the TBI population. Additional high-quality studies investigating how melatonin affects the sleep and functional recovery of individuals with TBIs are needed.