Melatonin: marvel or marker?

Analysis of Different Melatonin Secretion Patterns in Children With Sleep Disorders: Melatonin Secretion Patterns in Children

The objective of this study was to analyze circadian patterns of urinary 6-sulphatoxymelatonin (aMT6s) excretion in children with primary sleep disorders in comparison with healthy controls. A total of 124 control children and 124 patients (aged 4-14 years) diagnosed with diverse primary sleep disorders were recruited. aMT6s concentrations were measured in diurnal and nocturnal urine, as well as in 24-hour urine. aMT6s levels were significantly higher and showed significantly more evident circadian variations in the control group ( P < .001). Four different melatonin (aMT) production and excretion patterns were distinguished in the group with sleep disorders: (1) standard aMT production pattern, (2) low aMT production pattern, (3) aMT production pattern with absence of circadian variation, and (4) aMT hyperproduction pattern. This study highlights the importance of analyzing specific alterations of aMT secretion in each sleep disorder and provides evidences to explain why not all children with sleep disturbances do respond to aMT treatment.

Pay attention to evening owls

Our understanding on the functions of circadian clocks has deepened at a pace in recent years. Elucidation of the mechanisms of action might pave the way to a range of interventions of use in clinical practice in many fields of medicine.

Role of the melatonin system in the control of sleep: therapeutic implications

The circadian rhythm of pineal melatonin secretion, which is controlled by the suprachiasmatic nucleus (SCN), is reflective of mechanisms that are involved in the control of the sleep/wake cycle. Melatonin can influence sleep-promoting and sleep/wake rhythm-regulating actions through the specific activation of MT(1) (melatonin 1a) and MT(2) (melatonin 1b) receptors, the two major melatonin receptor subtypes found in mammals. Both receptors are highly concentrated in the SCN. In diurnal animals, exogenous melatonin induces sleep over a wide range of doses. In healthy humans, melatonin also induces sleep, although its maximum hypnotic effectiveness, as shown by studies of the timing of dose administration, is influenced by the circadian phase. In both young and elderly individuals with primary insomnia, nocturnal plasma melatonin levels tend to be lower than those in healthy controls. There are data indicating that, in affected individuals, melatonin therapy may be beneficial for ameliorating insomnia symptoms. Melatonin has been successfully used to treat insomnia in children with attention-deficit hyperactivity disorder or autism, as well as in other neurodevelopmental disorders in which sleep disturbance is commonly reported. In circadian rhythm sleep disorders, such as delayed sleep-phase syndrome, melatonin can significantly advance the phase of the sleep/wake rhythm. Similarly, among shift workers or individuals experiencing jet lag, melatonin is beneficial for promoting adjustment to work schedules and improving sleep quality. The hypnotic and rhythm-regulating properties of melatonin and its agonists (ramelteon, agomelatine) make them an important addition to the armamentarium of drugs for treating primary and secondary insomnia and circadian rhythm sleep disorders.

Complementary and alternative medicine for sleep disturbances in older adults

Complementary and alternative medicines (CAM) are frequently used for the treatment of sleep disorders, but in many cases patients do not discuss these therapies directly with their health care provider. There is a growing body of well-designed clinical trials using CAM that have shown the following: (1) Melatonin is an effective agent for the treatment of circadian phase disorders that affect sleep; however, the role of melatonin in the treatment of primary or secondary insomnia is less well established. (2) Valerian has shown a benefit in some, but not all clinical trials. (3) Several other modalities, such as Tai Chi, acupuncture, acupressure, yoga, and meditation have improved sleep parameters in a limited number of early trials. Future work examining CAM has the potential to significantly add to our treatment options for sleep disorders in older adults.

Aging-related oxidative stress in healthy humans

Oxidative stress has been reported to increase with aging; however, the scientific evidence is controversial. We therefore aimed to analyze the relationship between aging and some markers of oxidative stress. A cross-sectional and comparative study was carried out in a sample of 249 healthy subjects: (i) 25-29 years (n = 22); (ii) 30-39 years (24); (iii) 40-49 years (30); (iv) 50-59 years (48); (v) 60-69 years (60), and (vi) >or= 70 years (65). We measured lipoperoxides and total antioxidant status in plasma and superoxide dismutase and glutathione peroxidase activities in erythrocytes. There was an age-related increase in lipoperoxides, which was evident in the comparison of the group of 25-29 years (0.22 0.11 micromol/l) with the group of 60-69 years (0.38 +/- 0.18 micromol/l, p < 0.01) and >or= 70 years (0.42 +/- 0.19, p < 0.001). Conversely, the total antioxidant status showed an age-related decrease (25-29 years, 1.4 +/- 0.31 mmol/l vs 60-69 years, 1.1 +/- 0.21 and >or= 70 years, 1.1 +/- 0.22, p < 0.05 for each). In erythrocytes, glutathione peroxidase activity showed an age-related decrease (25-29 years, 7,966 +/- 1,813 UI/l vs 60-69 years, 6,193 +/- 2,235 and >or= 70 years, 6,547 +/- 2,307, p < 0.001 for each), whereas superoxide dismutase activity was similar in all age groups. Importantly, there was no age-related change in oxidative stress markers in subjects of < 60 years. These findings suggest that age of >or= 60 years may be associated with increased oxidative stress.

Circadian phase in adults of contrasting ages

There is evidence that aging may impair phase-shifting responses to light synchronizers, which could lead to disturbed or malsynchronized circadian rhythms. To explore this hypothesis, 62 elder participants (age, 58 to 84 years) and 25 young adults (age, 19 to 40 years) were studied, first with baseline 1-wk wrist actigraphy at home and then by 72 h in-laboratory study using an ultra-short sleep-wake cycle. Subjects were awake for 60 minutes in 50 lux followed by 30 minutes of darkness for sleep. Saliva samples were collected for melatonin, and urine samples were collected for aMT6s (a urinary metabolite of melatonin) and free cortisol every 90 minutes. Oral temperatures were also measured every 90 minutes. The timing of the circadian rhythms was not significantly more variable among the elders. The times of lights-out and wake-up at home and urinary free cortisol occurred earlier among elders, but the acrophases (cosinor analysis-derived peak time) of the circadian rhythm of salivary melatonin, urinary aMT6s, and oral temperature were not significantly phase-advanced among elders. The estimated duration of melatonin secretion was 9.9 h among elders and 8.4 h among young adults (p < 0.025), though the estimated half-life of blood melatonin was shorter among elders (p < 0.025), and young adults had higher saliva melatonin and urinary aMT6s levels. In summary, there was no evidence for circadian desynchronization associated with aging, but there was evidence of some rearrangement of the internal phase-angles among the studied circadian rhythms.

Associations of ambient illumination with mood: contribution of ophthalmic dysfunctions

Evidence suggests that ocular pathology could reduce light-stimulated neuronal signaling to the suprachiasmatic nuclei. This study investigated associations of ambient illumination with moods, while considering the contribution of ophthalmic dysfunctions. Seventy Black (59%) and White (41%) Americans participated in the study. Their average age was 68.27+/-5.97 years; 73% were women. Baseline data included: physical health, mood, and sociodemographics. Ophthalmic factors including visual acuity, visual field defects, intraocular pressure, vertical and horizontal cup-to-disk ratios, and nerve-fiber-layer thickness were assessed at SUNY Downstate's eye clinic. The following week, participants wore the Actiwatch-L at home to monitor ambient illumination and sleep. Cosine analyses were performed on the logarithm of measured illumination, yielding the mesor and acrophase of daily illumination exposure. Sleep was estimated with an automatic scoring algorithm. Of the sample, 25% reported visual impairment and 85% reported good to excellent health; 27% were visually impaired according to American criteria. Partial correlation analyses showed an inverse correlation of daily illumination levels to depressed mood [r(p)=-0.33, P<0.05], when age, sex, ethnicity, income, BMI, diabetes, hypertension, respiratory disease, and habitual sleep duration were controlled. With further control for ophthalmic factors, the magnitude and significance of the correlation diminished [r(p)=-0.26, NS]. Individuals receiving daily illumination later in the day reported more depressed moods [r(p)=0.36, P<0.01]; of note, this correlation was not significant after control for the covariates [r(p)=0.18, NS]. Regression analysis indicated that the ophthalmic factors explained 13% of the variance in depression. Our results show that both the level and timing of ambient illumination are associated with mood. Furthermore, they suggest that visual impairment has a mediating effect on the associations of ambient illumination with depression, supporting the notion that ocular pathology lessens the efficacy of daily illumination in promoting positive moods.

Efficacy of enhanced evening light for advanced sleep phase syndrome

This study tested whether a newly designed enhanced evening light therapy was well tolerated and effective in relieving symptoms of Advanced, Sleep Phase Syndrome (ASPS). Participants with self-reported ASPS symptoms were 47 older adults (21 men and 26 women, age 60-86). After baseline, participants underwent 28 consecutive days of either dim or enhanced intensity light treatment for 2-3 hr in the evening. Enhanced evening light (approximately 265 lux) exposure was no more effective than a placebo dim light (approximately 2 lux) at alleviating advanced sleep phase as measured by actigraphically recorded sleep and urinary 6-sulphatoxymelatonin (aMT6s) excretion patterns. Participants receiving the enhanced light reported subjective benefit and a significant delay in sleep onset as compared to the placebo. Although compliance was good and the new enhanced evening light therapy design was well tolerated, the benefits were statistically equivocal.

Association of morning illumination and window covering with mood and sleep among post-menopausal women

The antidepressant and sleep-promoting effects of light exposure might be useful for treating age-related mood and sleep disorders. In view of recent evidence suggesting beneficial effects of morning light, this study examined the associations of mood and sleep with morning light exposure, 24 h environmental illumination, and the degree to which the volunteers' bedroom windows were covered in the morning. We examined 459 postmenopausal women participating an ancillary study of the Women's Health Initiative conducted at the University of California, San Diego Clinical Center, San Diego, CA, USA. At baseline, volunteers completed a 4-week sleep-recall questionnaire. Volunteers were then assessed for 5-7 days in their home environments with actigraphic wrist monitors. During home recording, self-reported mood was assessed. Morning illumination during the first 4 h after arising, 24-h illumination mesor (cosine-fitted mean), and illumination acrophase (cosine-fitted peak time) were calculated. Sleep was scored each night using validated wrist actigraphic methods. A sleep diary was completed each morning. During two 24-h periods, urine was collected approximately every 2 h during wakefulness and following any voidings during the sleep period. Cosine-fitting established the acrophase of urinary 6-sulfatoxymelatonin (aMT6s) excretion. Morning illumination and 24-h illumination were modestly associated with better mood and sleep. Associations of light with mood and sleep were consistently greater for subjects whose body clocks were delayed relative to the group median. Less morning window covering in the subjects' bedrooms was associated with more morning light and less depressed mood. The results suggest that both morning and 24-h light exposure may be beneficial for older adults.

Ethnicity, sleep, mood, and illumination in postmenopausal women

BACKGROUND

This study examined how ethnic differences in sleep and depression were related to environmental illumination and circadian rhythms.

METHODS

In an ancillary study to the Women's Health Initiative, 459 postmenopausal women were recorded for one week in their homes, using wrist monitors. Sleep and illumination experience were estimated. Depression was self-rated with a brief adjective check list. Affective diagnoses were made using the SCID interview. Sleep disordered breathing was monitored with home pulse oximetry.

RESULTS

Hispanic and African-American women slept less than European-American women, according to both objective recordings and their own sleep logs. Non-European-American women had more blood oxygen desaturations during sleep, which accounted for 26% of sleep duration variance associated with ethnicity. Hispanic women were much more depressed. Hispanic, African-American and Native-American women experienced less daily illumination. Less daily illumination experience was associated with poorer global functioning, longer but more disturbed sleep, and more depression.

CONCLUSIONS

Curtailed sleep and poor mood were related to ethnicity. Sleep disordered breathing was a factor in the curtailed sleep of minority women. Less illumination was experienced by non-European-American women, but illumination accounted for little of the contrasts between ethnic groups in sleep and mood. Social factors may be involved.

Nocturnal 6-sulfatoxymelatonin excretion in insomnia and its relation to the response to melatonin replacement therapy

PURPOSE

Melatonin, which is produced by the pineal gland at night, is an endogenous sleep regulator. Both sleep disorders and impaired melatonin production are common among the elderly. We examined the excretion of the major melatonin metabolite 6-sulfatoxymelatonin in insomnia patients aged >or=55 years and its relation with the subsequent response to melatonin therapy.

METHODS

We studied 517 insomnia patients, along with 29 age-matched and 30 younger healthy volunteers. Nocturnal urinary 6-sulfatoxymelatonin excretion was assessed between 10 pm and 10 am. Three hundred and ninety-six of the insomnia patients were treated for 2 weeks with placebo and for 3 weeks with 2 mg per night of controlled-release melatonin, of which 372 provided complete datasets. Clinical response, assessed with the Leeds Sleep Evaluation Questionnaire, was defined as an improvement of 10 mm or more on the visual analog scales.

RESULTS

Mean (+/- SD) 6-sulfatoxymelatonin excretion was lower in the insomnia patients (9.0 +/- 8.3 microg per night) than in volunteers of the same age (18.1 +/- 12.7 microg per night, P <0.05) and in younger volunteers (24.2 +/- 11.9 microg per night, P <0.05). About 30% of patients (112/372) excreted <or=3.5 microg of sulfatoxymelatonin per night, which is considered to be lower than normal for this age group. These "low excretors" had a significantly higher response to melatonin replacement therapy (58% [65/112] vs. 47% [122/260], P <0.05).

CONCLUSION

Low nocturnal melatonin production is associated with insomnia in patients aged 55 years or older, and identifies patients who are somewhat more likely to respond to melatonin replacement.

Melatonin excretion with affect disorders over age 60

Numerous studies have reported low melatonin secretion in depression, but other studies have suggested no deficit or an increase. Alterations of circadian phase or duration of melatonin secretion have also been described. Since melatonin secretion decreases as we age, it seemed interesting to examine melatonin and depression in an aging sample. Volunteers who complained of mood or sleep problems were recruited for studies in which fractional urine specimens were collected for 24 h, both at home and in the laboratory. The major metabolite, 6-sulfatoxymelatonin (aMT6s), was determined by radioimmunoassay. Of 72 volunteers aged 60-78 years, seven had current major depression and 55% had a lifetime history of an affective disorder. A 55-fold range of home aMT6s excretion rates was observed. A lifetime history of any affective disorder was significantly associated with greater log(10)[mesor] aMT6s excretion in home collections and laboratory collections, but current affective disorders were neither significantly related to melatonin excretion nor to aMT6s acrophase timing, onset, offset or duration. These results are only weakly consistent with a photoperiodic hypothesis of depression.

Sleep Complaints of Postmenopausal Women

OBJECTIVE: To study correlates of sleep problems in postmenopausal women. METHODS: Baseline questionnaire items related to sleep patterns and problems were administered to 98,705 postmenopausal women as part of the Clinical Trial and the Observational Study of the Women's Health Initiative. RESULTS: Less than 27% of the sample reported sleeping 8 hours or more. Many women reported that at least once a week they awoke several times at night (61%), fell asleep during quiet activities (52%), or reported other symptoms suggestive of insomnia or excessive daytime sleepiness. More frequent insomnia problems were reported among women who reported nocturnal sleep longer than the mode of 7 hours, as well as among women who reported very short sleep. Age, ethnicity, hormone replacement therapy, employment, marital status, diet, and season explained remarkably little of the variance in sleep duration or insomnia complaints; however, black women reported sleeping 0.45 hours on average less than whites, with the other minorities being intermediate between these groups. CONCLUSIONS: The results suggest that simple abbreviation of sleep and demographic factors may be less important in the sleep complaints of postmenopausal women than other possible factors. Cognitive-behavioral processes, depression, and obesity with apnea may be among the causes.

Brain structures and mechanisms involved in the generation of NREM sleep: focus on the preoptic hypothalamus

Four lines of research have greatly increased our understanding of the hypothalamic preoptic area (POA) sleep-promoting system. First, sleep-active neurons within the POA have been identified using both electrophysiological recording and immediate early gene protein (c-Fos) staining methods. Segregated sleep-active neurons were found in ventrolateral and median POA (VLPO and MnPN). Additional sleep-active neurons may be intermixed with non-sleep specific neurons in other POA regions and the adjacent basal forebrain. Second, the putative sleep factors, adenosine and prostaglandin D2, were found to excite sleep-active neurons. Other sleep factors may also modulate these sleep-active populations. Third, many sleep-active neurons are warm-sensitive neurons (WSNs). WSNs are identified by excitatory responses to small increases in local POA temperature. The same local POA thermal stimuli strongly modulate sleep propensity and EEG delta activity within sleep. Interactions between sleep regulation and thermoregulation are consistent with studies of circadian sleep propensity, prolonged sleep deprivation in rats, and species differences in sleep amounts. Fourth, sleep-active neurons were found to co-localize the inhibitory neurotransmitter, gamma-aminobutyric acid and to have projections to arousal-related neuronal subgroups in the posterior hypothalamus and midbrain. Sleep-active and arousal-related neurons exhibit reciprocal changes in discharge across the wake-NREM-REM cycle, and activation of WSNs suppresses the neuronal activity of some arousal-related neuronal groups. These studies establish mechanisms by which POA hypnogenic neurons can inhibit EEG and behavioral arousal. In addition, there is evidence that arousal-related neurotransmitters inhibit VLPO sleep-active neurons. Mutually inhibitory interactions between sleep-promoting and the arousal system provide a substrate for a <<<<sleep-wake switch>>>>. 2001 Harcourt Publishers Ltd

Total antioxidant levels, gender, and age as risk factors for DNA damage in lymphocytes of the elderly

During past years, the association of oxidative stress with DNA damage and its possible clinical translation into chronic degenerative illnesses, such as atherosclerosis, cancer, diabetes mellitus and Alzheimer's disease, has been demonstrated. In addition, it has been pointed out that age and gender are factors that influence the generation of DNA damage; however, this is still controversial. We have previously reported the results of a study of 88 subjects older than 60 years of age in whom DNA damage is related with serum levels of total antioxidants. The results of this study demonstrate a greater frequency of DNA damage in elderly persons with normal levels of antioxidants, in addition to males, and in the younger group of subjects, i.e., 60-69 years. In this work, we enlarged our study sample to 160 elderly subjects; in this way, we were able to evaluate the consistency of the influence of total antioxidants, age, and gender on the magnitude and grade of DNA damage in lymphocytes of the elderly. The results demonstrated that 45% of the subjects showed DNA damage, measured by an alkaline unicellular electrophoresis technique (comet assay). Similarly, 62% of the subjects presented low levels of total antioxidant levels measured by a colorimetric method (Randox Kit). A greater percentage of DNA damage was observed in subjects with normal levels of antioxidants (48%) compared with subjects with low levels (43%), although the difference was not statistically significant. The group of subjects 70 years of age or older showed a greater percentage of DNA damage (50%) than the group of subjects of 60-69 years of age (41%). However, the difference was again not statistically significant (P>0.05). With respect to gender, 64% of males and 38% of females had DNA damage with an odds ratio (OR) of 2.86 and a 95% confidence interval (CI) of 1.31-6.32 (P<0.05). In the logistic regression analysis, the interaction of the male sex variables with low antioxidants had an OR of 2.5 (CI 95%, 1.33-4.68; P<0.01). We conclude that the interaction of male sex factors-low levels of antioxidants would justify the indication of antioxidant dietetic supplements.

Melatonin receptors and ligands

The goal of the article is to provide a clearer understanding of how melatonin and its related analogs interact with melatonin receptors with the hope of developing important tools and agents of significant clinical and scientific importance. The review provides a compilation of the currently published melatonergic ligands and their relative affinities for melatonin receptors and discusses the importance of developing reversible, high-affinity, and subtype selective melatonin receptor antagonists. In addition, the review discusses the utility of developing high-affinity charged melatonergic ligands and irreversible ligands. Finally, the review discusses some of the problems associated with the current models used to study receptor pharmacology and function. As the availability of tools increases in the melatonin receptor field, a great body of knowledge is also gained about the structure of the melatonin receptor and the role that specific melatonin receptor subtypes have in physiologic processes. Further design, synthesis, and application of melatonergic ligands will lead us to a clearer understanding of the role that melatonin and its receptors play in humans.

Circadian sleep, illumination, and activity patterns in women: influences of aging and time reference

Patterns of sleep, illumination, and activity of women of different ages were continuously monitored in their natural environments with a wrist activity monitor. Partial correlation analyses were performed to determine relationships between age and sleep and several circadian rhythm measures including the amplitudes, mesors, and timings of sleep, of illumination, and of activity. We found no age-related decline in actigraphic sleep duration. Age was not a significant correlate of circadian rhythm parameters of sleep. Moreover, no age effects were found on daily illumination exposure or on the circadian timing of illumination and activity patterns. However, the level and amplitude of the circadian activity rhythm showed a gradual decline with aging, independent of the time reference (i.e., Daylight Saving Time versus Standard Time) when recordings were obtained. As expected, significant associations were observed between local time reference and the level and timing of peak of illumination patterns. However, changes in local time reference were not significantly and consistently associated with actigraphic sleep or activity measures.

Do plasma melatonin concentrations decline with age?

PURPOSE

Numerous reports that secretion of the putative sleep-promoting hormone melatonin declines with age have led to suggestions that melatonin replacement therapy be used to treat sleep problems in older patients. We sought to reassess whether the endogenous circadian rhythm of plasma melatonin concentration changes with age in healthy drug-free adults.

METHODS

We analyzed the amplitude of plasma melatonin profiles during a constant routine in 34 healthy drug-free older subjects (20 women and 14 men, aged 65 to 81 years) and compared them with 98 healthy drug-free young men (aged 18 to 30 years).

RESULTS

We could detect no significant difference between a healthy and drug-free group of older men and women as compared to one of young men in the endogenous circadian amplitude of the plasma melatonin rhythm, as described by mean 24-hour average melatonin concentration (70 pmol/liter vs 73 pmol/liter, P = 0.97), or the duration (9.3 hours vs 9.1 hours, P = 0.43), mean (162 pmol/liter vs 161 pmol/liter, P = 0.63), or integrated area (85,800 pmol x min/liter vs 86,700 pmol x min/liter, P = 0.66) of the nocturnal peak of plasma melatonin.

CONCLUSION

These results do not support the hypothesis that reduction of plasma melatonin concentration is a general characteristic of healthy aging. Should melatonin replacement therapy or melatonin supplementation prove to be clinically useful, we recommend that an assessment of endogenous melatonin be carried out before such treatment is used in older patients.

Approaches to anti-aging intervention: the promises and the uncertainties

Humans have long sought the elixir to long life. Today, although advances in our understanding of the aging process have given gerontologists new insights in potential anti-aging interventions, public demand for these interventions is outpacing our current knowledge. My presentation begins with a brief historical background that outlines some of the past and present approaches to anti-aging interventions. Using the dietary restriction paradigm as a prototype, discussions center on a three-pathway model that provides the bases to design effective interventions: (1) retardation of biological aging, (2) suppression of age-related disease, and (3) modulation of cross talk between (1) and (2). One other concept useful for discussion in relation to interventions is the enhancement of an organism's resistance to deter vulnerability to aging and disease. These models are best used to explain the efficacy of currently popular interventions such as antioxidant supplementation and hormone therapies. This presentation further highlights the promises that antioxidant supplements hold in warding off oxidative damage as well as their inherent problems and biological limitations. Also discussed here are the promises and uncertainties of anti-aging interventions by genetic manipulation, as seen in animal model studies, and prophylactic treatments targeted against disease, such as hormonal approaches using estrogen and DHEA, as well as other intervening measures.

Daily rhythm of serum melatonin levels and effect of light exposure in patients with dementia of the Alzheimer's type

BACKGROUND

Several studies have suggested that patients with dementia experience a deterioration of biological rhythms. We investigated the daily profile of serum melatonin levels in patients with dementia of the Alzheimer's type (AD), since daily melatonin rhythm is thought to reflect the functioning of the biological clock.

METHODS

Seventeen inpatients with AD, 10 psychiatric inpatients without dementia, and 11 elderly healthy volunteers participated in this study. Serum melatonin was assessed every 3 hours by radioimmunoassay.

RESULTS

A daily fluctuation of melatonin levels with a significant nocturnal increase was observed in all three subject groups. However, both the AD patients and psychiatric patients without dementia showed significantly higher levels of melatonin in the daytime compared with the healthy subjects. When the effect of bright light exposure on melatonin secretion was investigated in six AD patients and five psychiatric patients without dementia, the daytime levels were markedly decreased in the patients without dementia, while no change was observed in the AD patients.

CONCLUSIONS

The high levels of melatonin in the daytime associated with a lack of response to light exposure in AD patients may be due to the neurodegenerative process of this disease.

The relationship between 6-sulphatoxymelatonin and polysomnographic sleep in good sleeping controls and wake maintenance insomniacs, aged 55-80 years

The pineal hormone, melatonin, is reported to possess hypnotic properties. This has led to an investigation of the relationship between the endogenous melatonin rhythm and sleep. However, this relationship has yet to be fully examined in aged insomniacs and controls. From media advertisements, 16 good sleeping controls (11F, 5M) and 16 sleep maintenance insomniacs (11F, 5M), aged over 55 years, were recruited to participate in a study involving four nights of polysomnographically (PSG) measured sleep followed by a 26 h constant routine. During the constant routine, 2 h urine samples were collected and analysed for the melatonin metabolite, 6-sulphatoxymelatonin (aMT.6S). This was used to determine total melatonin excretion. As well, the following circadian melatonin parameters were calculated from fifth order polynomial curve fitting analyses, the goodness of the polynomial curve fit, peak melatonin concentration, the phase of the melatonin rhythm, and melatonin and sleep rhythm synchrony. Apart for one control, all subjects showed significant circadian melatonin rhythms. Although insomniacs showed a greater amount of wakefulness, less sleep in total, and lower sleep efficiency, no significant group differences were observed in any of the melatonin parameters. In addition, while subjects with more reliable melatonin curve fits showed shorter sleep latencies and higher sleep efficiencies, correlational analyses revealed no other significant relationships between any melatonin and PSG sleep parameters. Overall, the present results suggest that neither melatonin amplitude nor phase are related to sleep quality in the aged.