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

*Corresponding author for this work

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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
Article number18
Number of pages18
JournalBMC Medicine
Volume16
DOIs
Publication statusPublished - 5 Feb 2018

Keywords

  • melatonin
  • systematic reviews

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    Posadzki, P. P., Bajpai, R., Kyaw, B. M., Roberts, N. J., Brzezinski, A., Christopoulos, G. I., Divakar, U., Bajpai, S., Soljak, M., Dunleavy, G., Jarbrink, K., Nang, E. E. K., Soh, C. K., & Car, J. (2018). Melatonin and health: an umbrella review of health outcomes and biological mechanisms of action. BMC Medicine, 16, [18]. https://doi.org/10.1186/s12916-017-1000-8