Complementary, Holistic, and Integrative Medicine: Melatonin
Bibliographic record
Abstract
1. Larissa Shamseer* 2. Sunita Vohra, MD, MSc* 1. *Complementary and Alternative Research and Education (CARE) Program, Department of Pediatrics, Faculty of Medicine, University of Alberta. On behalf of the American Academy of Pediatrics Section on Complementary and Integrative Medicine Melatonin is synthesized primarily in the pineal gland, although it also can be produced in the retina and gastrointestinal tract. Melatonin helps regulate circadian rhythms, specifically sleep-wake cycles. These cycles are under the control of the suprachiasmatic nucleus, through which patterns of light and darkness are transferred from the retina to the pineal gland. Melatonin is formed from the essential amino acid tryptophan via serotonin, based on specific patterns. Simply stated, in the presence of light, melatonin production is inhibited; in the darkness, it is synthesized. Melatonin also can be taken as an exogenous supplement, which is synthesized to be chemically identical to its endogenous counterpart, and is classified as a natural health product by Health Canada or dietary supplement by the United States Food and Drug Administration. Due to its involvement in the sleep cycle, exogenous melatonin has been investigated extensively for sleep disorders. Difficulties initiating and maintaining sleep affect 15% to 25% of the pediatric population. Thirty minutes is believed to be the normal time to initiate sleep or sleep onset latency (SOL), which is defined as the amount of time between the person laying down to sleep and the onset of stage 1 sleep. (1)(2)(3)(4) A difference of 15 minutes in SOL typically is considered clinically important. (4) The literature evaluating melatonin for the treatment of sleep disorders was reviewed systematically in 2004 by the Agency for Healthcare Research and Quality (AHRQ). (5) Efficacy reports of melatonin for primary and secondary sleep disorders, including examination of pediatric subgroups, appeared in subsequent publications following the AHRQ report. Findings indicate that melatonin may be safe and effective for managing some primary (Table 1) and secondary (Table 2) sleep disorders. | Author and Year | Study Design | Population | Intervention/Control | Dose/Frequency/Duration | Outcome | |:----------------:| ------------ | -------------------------------------------------- | ------------------------- | ----------------------------------------------------- | ----------------------------------------------- | | Buscemi 2005 (6) | SR | N: 2 RCTs; 110 participants | I: Fast-release melatonin | 5 mg/once per day before bedtime/4 weeks of treatment | Reduction in SOL: 16.7 min (95% CI −29.4, −4.0) | | | | Age: 0 to 18 years | C: Identical placebo | | | | Condition: idiopathic chronic sleep-onset insomnia | | | * CI=confidence interval, RCT=randomized, controlled trial, SOL=sleep-onset latency, SR=systematic review Table 1. Study of Melatonin in …
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.002 | 0.001 |
| Open science | 0.000 | 0.002 |
| Research integrity | 0.001 | 0.002 |
| Insufficient payload (model declined to judge) | 0.010 | 0.003 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".