Melatonin and health: an umbrella review of health outcomes and biological mechanisms of action

Pawel P. Posadzki, Ram Bajpai, Bhone Myint Kyaw, Nicola J. Roberts, Amnon Brzezinski, George I. Christopoulos, Ushashree Divakar, Shweta Bajpai, Michael Soljak, Gerard Dunleavy, Krister Jarbrink, Ei Ei Khaing Nang, Chee Kiong Soh, Josip Car

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Abstract

Background: Our aim was to critically evaluate the evidence from systematic reviews as well as narrative reviews of the effects of melatonin (MLT) on health; and to identify the potential mechanisms of action involved.
Methods: An umbrella review of the evidence across systematic reviews and narrative reviews of endogenous and exogenous (supplementation) MLT was undertaken. The Oxman checklist for assessing the methodological quality of the included SRs was utilised. The following databases were searched: MEDLINE, EMBASE, Web of Science, CENTRAL, PsycINFO, and CINAHL as well as screening of reference lists. We included reviews of the effects of MLT on any type of health-related outcome measures.
Results: One hundred and ninety-five reviews met the inclusion criteria. Most were of low methodological quality (mean=-4.5, standard deviation=6.7). Of those, 164 did not pool the data and were synthesised narratively (qualitatively) whereas the remaining 31 used meta-analytic techniques and were synthesised quantitatively. Seven meta-analyses were significant with P values less than 0.001 under the random-effects model. These pertained to sleep latency, pre-operative anxiety, prevention of agitation, and risk of breast cancer.
Conclusions: There is an abundance of reviews evaluating the effects of exogenous and endogenous MLT on health. In general, MLT has been shown to be associated with a wide variety of health outcomes in clinically and methodologically heterogeneous populations. Many reviews stressed the need for more high quality randomised clinical trials to reduce the existing uncertainties.
Original languageEnglish
JournalBMC Medicine
DOIs
Publication statusPublished - 5 Feb 2018

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Melatonin
Health
Checklist
MEDLINE
Action Potentials
Uncertainty
Meta-Analysis
Sleep
Anxiety
Randomized Controlled Trials
Outcome Assessment (Health Care)
Databases
Breast Neoplasms
Population

Keywords

  • melatonin
  • systematic reviews

Cite this

Posadzki, Pawel P. ; Bajpai, Ram ; Kyaw, Bhone Myint ; Roberts, Nicola J. ; Brzezinski, Amnon ; Christopoulos, George I. ; Divakar, Ushashree ; Bajpai, Shweta ; Soljak, Michael ; Dunleavy, Gerard ; Jarbrink, Krister ; Nang, Ei Ei Khaing ; Soh, Chee Kiong ; Car, Josip . / Melatonin and health: an umbrella review of health outcomes and biological mechanisms of action. In: BMC Medicine. 2018.
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abstract = "Background: Our aim was to critically evaluate the evidence from systematic reviews as well as narrative reviews of the effects of melatonin (MLT) on health; and to identify the potential mechanisms of action involved. Methods: An umbrella review of the evidence across systematic reviews and narrative reviews of endogenous and exogenous (supplementation) MLT was undertaken. The Oxman checklist for assessing the methodological quality of the included SRs was utilised. The following databases were searched: MEDLINE, EMBASE, Web of Science, CENTRAL, PsycINFO, and CINAHL as well as screening of reference lists. We included reviews of the effects of MLT on any type of health-related outcome measures. Results: One hundred and ninety-five reviews met the inclusion criteria. Most were of low methodological quality (mean=-4.5, standard deviation=6.7). Of those, 164 did not pool the data and were synthesised narratively (qualitatively) whereas the remaining 31 used meta-analytic techniques and were synthesised quantitatively. Seven meta-analyses were significant with P values less than 0.001 under the random-effects model. These pertained to sleep latency, pre-operative anxiety, prevention of agitation, and risk of breast cancer. Conclusions: There is an abundance of reviews evaluating the effects of exogenous and endogenous MLT on health. In general, MLT has been shown to be associated with a wide variety of health outcomes in clinically and methodologically heterogeneous populations. Many reviews stressed the need for more high quality randomised clinical trials to reduce the existing uncertainties.",
keywords = "melatonin, systematic reviews",
author = "Posadzki, {Pawel P.} and Ram Bajpai and Kyaw, {Bhone Myint} and Roberts, {Nicola J.} and Amnon Brzezinski and Christopoulos, {George I.} and Ushashree Divakar and Shweta Bajpai and Michael Soljak and Gerard Dunleavy and Krister Jarbrink and Nang, {Ei Ei Khaing} and Soh, {Chee Kiong} and Josip Car",
note = "OA article Funding note: This material is based on research and work supported by award L2NICCFP1-2013-2 to principal investigator CKS from the Land and Liveability National Innovation Challenge (L2 NIC)). Any opinions, findings, conclusions or recommendations expressed in this material are those of the author(s) and do not necessarily reflect the views of L2 NIC.",
year = "2018",
month = "2",
day = "5",
doi = "10.1186/s12916-017-1000-8",
language = "English",
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Posadzki, PP, Bajpai, R, Kyaw, BM, Roberts, NJ, Brzezinski, A, Christopoulos, GI, Divakar, U, Bajpai, S, Soljak, M, Dunleavy, G, Jarbrink, K, Nang, EEK, Soh, CK & Car, J 2018, 'Melatonin and health: an umbrella review of health outcomes and biological mechanisms of action', BMC Medicine. https://doi.org/10.1186/s12916-017-1000-8

Melatonin and health: an umbrella review of health outcomes and biological mechanisms of action. / Posadzki, Pawel P.; Bajpai, Ram ; Kyaw, Bhone Myint ; Roberts, Nicola J.; Brzezinski, Amnon ; Christopoulos, George I.; Divakar, Ushashree ; Bajpai, Shweta; Soljak, Michael; Dunleavy, Gerard ; Jarbrink, Krister ; Nang, Ei Ei Khaing ; Soh, Chee Kiong; Car, Josip .

In: BMC Medicine, 05.02.2018.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Melatonin and health: an umbrella review of health outcomes and biological mechanisms of action

AU - Posadzki, Pawel P.

AU - Bajpai, Ram

AU - Kyaw, Bhone Myint

AU - Roberts, Nicola J.

AU - Brzezinski, Amnon

AU - Christopoulos, George I.

AU - Divakar, Ushashree

AU - Bajpai, Shweta

AU - Soljak, Michael

AU - Dunleavy, Gerard

AU - Jarbrink, Krister

AU - Nang, Ei Ei Khaing

AU - Soh, Chee Kiong

AU - Car, Josip

N1 - OA article Funding note: This material is based on research and work supported by award L2NICCFP1-2013-2 to principal investigator CKS from the Land and Liveability National Innovation Challenge (L2 NIC)). Any opinions, findings, conclusions or recommendations expressed in this material are those of the author(s) and do not necessarily reflect the views of L2 NIC.

PY - 2018/2/5

Y1 - 2018/2/5

N2 - Background: Our aim was to critically evaluate the evidence from systematic reviews as well as narrative reviews of the effects of melatonin (MLT) on health; and to identify the potential mechanisms of action involved. Methods: An umbrella review of the evidence across systematic reviews and narrative reviews of endogenous and exogenous (supplementation) MLT was undertaken. The Oxman checklist for assessing the methodological quality of the included SRs was utilised. The following databases were searched: MEDLINE, EMBASE, Web of Science, CENTRAL, PsycINFO, and CINAHL as well as screening of reference lists. We included reviews of the effects of MLT on any type of health-related outcome measures. Results: One hundred and ninety-five reviews met the inclusion criteria. Most were of low methodological quality (mean=-4.5, standard deviation=6.7). Of those, 164 did not pool the data and were synthesised narratively (qualitatively) whereas the remaining 31 used meta-analytic techniques and were synthesised quantitatively. Seven meta-analyses were significant with P values less than 0.001 under the random-effects model. These pertained to sleep latency, pre-operative anxiety, prevention of agitation, and risk of breast cancer. Conclusions: There is an abundance of reviews evaluating the effects of exogenous and endogenous MLT on health. In general, MLT has been shown to be associated with a wide variety of health outcomes in clinically and methodologically heterogeneous populations. Many reviews stressed the need for more high quality randomised clinical trials to reduce the existing uncertainties.

AB - Background: Our aim was to critically evaluate the evidence from systematic reviews as well as narrative reviews of the effects of melatonin (MLT) on health; and to identify the potential mechanisms of action involved. Methods: An umbrella review of the evidence across systematic reviews and narrative reviews of endogenous and exogenous (supplementation) MLT was undertaken. The Oxman checklist for assessing the methodological quality of the included SRs was utilised. The following databases were searched: MEDLINE, EMBASE, Web of Science, CENTRAL, PsycINFO, and CINAHL as well as screening of reference lists. We included reviews of the effects of MLT on any type of health-related outcome measures. Results: One hundred and ninety-five reviews met the inclusion criteria. Most were of low methodological quality (mean=-4.5, standard deviation=6.7). Of those, 164 did not pool the data and were synthesised narratively (qualitatively) whereas the remaining 31 used meta-analytic techniques and were synthesised quantitatively. Seven meta-analyses were significant with P values less than 0.001 under the random-effects model. These pertained to sleep latency, pre-operative anxiety, prevention of agitation, and risk of breast cancer. Conclusions: There is an abundance of reviews evaluating the effects of exogenous and endogenous MLT on health. In general, MLT has been shown to be associated with a wide variety of health outcomes in clinically and methodologically heterogeneous populations. Many reviews stressed the need for more high quality randomised clinical trials to reduce the existing uncertainties.

KW - melatonin

KW - systematic reviews

U2 - 10.1186/s12916-017-1000-8

DO - 10.1186/s12916-017-1000-8

M3 - Article

JO - BMC Medicine

JF - BMC Medicine

SN - 1741-7015

ER -