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Exogenous melatonin for sleep disorders in neurodegenerative diseases: a meta-analysis of randomized clinical trials

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Abstract

The purpose of this work is to investigate the efficacy of exogenous melatonin in the treatment of sleep disorders in patients with neurodegenerative disease. We searched Pubmed, the Cochrane Library, and ClinicalTrials.gov, from inception to July 2015. We included randomized clinical trials (RCTs) that compared melatonin with placebo and that had the primary aim of improving sleep in people with neurodegenerative diseases, particularly Alzheimer’s disease (AD) and Parkinson’s disease (PD). We pooled data with the weighted mean difference in sleep outcomes. To assess heterogeneity in results of individual studies, we used Cochran’s Q statistic and the I 2 statistic. 9 RCTs were included in this research. We found that the treatment with exogenous melatonin has positive effects on sleep quality as assessed by the Pittsburgh Sleep Quality Index (PSQI) in PD patients (MD: 4.20, 95 % CI: 0.92–7.48; P = 0.01), and by changes in PSQI component 4 in AD patients (MD: 0.67, 95 % CI: 0.04–1.30; P = 0.04), but not on objective sleep outcomes in both AD and PD patients. Treatment with melatonin effectively improved the clinical and neurophysiological aspects of rapid eye movement (REM) sleep behavior disorder (RBD), especially elderly individuals with underlying neurodegenerative disorders. This meta-analysis provided some evidence that melatonin improves sleep quality in patients with AD and PD, and melatonin can be considered as a possible sole or add-on therapy in neurodegenerative disorders patients with RBD.

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Acknowledgments

The study was supported by the Natural Science Foundation of China (NSFC, 81273600; 30970659), the Natural Science Foundation of Hebei Province (H2013206147; C2011206145), Hebei Key Technology Support Program (12276405D), the Department of Health of Hebei Province (20090047), and China Rehabilitation Research Center optional research project (2014-7). The funders had no role in study design, data collection and analysis, decision to publish or preparation of the manuscript.

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Authors and Affiliations

  1. Capital Medical University School of Rehabilitation Medicine, China Rehabilitation Research Center, 10, Jiaomenbei Road, FengTai District, Beijing, 100068, China

    Wei Zhang & Tong Zhang

  2. Department of Pharmacology, Hebei Medical University, 361, Zhongshan East Road, Shijiazhuang, 050017, China

    Xue-yan Chen, Su-wen Su, Qing-zhong Jia & Zhong-ning Zhu

  3. Department of Pathology, School of Basic Medicine, Hebei University of Chinese Medicine, 3, Xingyuan Road, Luquan, Shijiazhuang, 050200, China

    Tao Ding

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  1. Wei Zhang
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Correspondence to Zhong-ning Zhu or Tong Zhang.

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Zhang, W., Chen, Xy., Su, Sw. et al. Exogenous melatonin for sleep disorders in neurodegenerative diseases: a meta-analysis of randomized clinical trials. Neurol Sci 37, 57–65 (2016). https://doi.org/10.1007/s10072-015-2357-0

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  • DOI: https://doi.org/10.1007/s10072-015-2357-0

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