TRIO Best Practice articles are brief, structured reviews designed to provide the busy clinician with a handy outline and reference for day-to-day clinical decision making. The ENTtoday summaries below include the Background and Best Practice sections of the original article. To view the complete Laryngoscope articles free of charge, visit Laryngoscope.com.
Melatonin has long been used as an over-the-counter aid to assist with hastening sleep onset and treating symptoms of jet lag, with jet lag being the most common application. The effects of jet lag are greater based on an increase in the number of time zones travelled and when experiencing eastbound travel. Jet lag may have varying effects on an individual, and is associated with cognitive and physiological deficits. Insomnia and constant sleepiness may also occur during the day. Other negative effects may include reduced attention, altered mood states, diminished memory processing, and altered executive functioning. Melatonin has numerous commercially available preparations, and in most countries is not considered a regulated substance. Despite its widespread use as a sleep aid, and its promotion as such by celebrity entertainers and media-based physicians alike, it remains unclear whether or not there is sufficient evidence to support the recommendation of this substance as a sleep aid.
Melatonin can be a useful tool to counter the effects of jet lag on human sleep-phase shifting when administered at the proper time. Greater effects seen in sleep-phase shift occur when the patient is treated in conjunction with light therapy. Although the current literature is not sufficient to evaluate all the various commercially available preparations of melatonin, it does seem that this over-the-counter supplement generally has a meaningful effect on human sleep, and in particular the treatment of jet lag. Larger trials of high-level evidence would be preferred to support a firm recommendation to take melatonin as routine therapy for those suffering from jet lag, but the current evidence is strong enough for clinicians to offer this as an option to patients (Laryngoscope. 2016;126:1719–1720).