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A more adequate question to ask would be: "Is melatonin a useful sleep remedy?"

One in five Americans suffers from some kind of sleep disorder. Sleep disorders are defined by a poor quality sleep that may result in daytime sleepiness or impaired functioning. These disorders may be either secondary to several medical or psychiatric diseases (such as depression) or primary (i.e. not related to any other abnormal conditions). The most common sleep disorders are insomnia and the delayed sleep phase syndrome (DSPS). The latter is characterized by difficulties in both falling asleep and in waking-up when planned (Buscemi et al., 2005).

Melatonin is a pineal gland hormone, involved in the regulation of sleep-wake cycles in humans. It has been largely used for many years now to treat sleep troubles, and it is generally viewed as a natural, effective and safe remedy (Devi & Shankar, 2008). However, its popularity has recently been questioned by some reviewers that analyzed the results of melatonin use in various studies.

Buscemi and co-workers (Buscemi et al., 2005) performed a systematic review of melatonin efficacy and safety in the management of primary sleep disorders. Fourteen randomized controlled trials (RCTs) were relevant to the efficacy review, including 279 participants. [An RCT is a high-quality research, where a group of subjects is randomly assigned to receive either the active drug (melatonin, in this case), or placebo (a neutral, inactive, and harmless substance), allowing for a statistical comparison of results between the two subgroups.] The authors found that, overall, melatonin reduced sleep onset latency by no more than 11 minutes, and by only 7 minutes in people with insomnia. These gains were seen as insignificant. A more important benefit was observed in the subpopulation with DSPS, where the average reduction in sleep onset latency was 39 minutes; however, this was based on only two studies involving less than 30 subjects (Buscemi et al., 2005). Ten studies (nine RCTs), concerning some 222 participants, were relevant to the safety review. The duration of melatonin administration was 3 months or less. There were few reports of adverse events after melatonin administration. The most common adverse events reported were headaches (13 events), dizziness (10 events), nausea (3 events), and drowsiness (3 events), but in all cases, there was no significant difference between melatonin and placebo (Buscemi et al., 2005).

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