| Medical Condition | Uses based on scientific evidence | Grade* |
| alzheimer's disease | there is limited study of melatonin for improving sleep disorders associated with alzheimer's disease (including nighttime agitation or poor sleep quality in patients with dementia). it has been reported that natural melatonin levels are altered in people with alzheimer's disease, although it remains unclear if supplementation with melatonin is beneficial. further research is needed in this area before a firm conclusion can be reached. | c |
| attention deficit disorder of childhood with hyperactivity | there is limited research on the use of melatonin in children with adhd both for the treatment of adhd and insomnia in adhd children. beneficial effects in sleep quality have been reported; however, no effect on behavior problems has been noted. a clear conclusion cannot be made at this time. | c |
| bipolar disorder, other | there is limited study of melatonin given to patients with sleep disturbances associated with bipolar disorder (such as insomnia or irregular sleep patterns). no clear benefits have been reported. further research is needed in this area before a clear conclusion can be reached. | c |
| cerebral artery occlusion unspecified with cerebral infarction | at this time, the effects of melatonin supplements immediately after stroke are not clear. | c |
| chronic fatigue syndrome | there is limited study of melatonin given to patients with chronic fatigue syndrome. benefits have been reported. further research is needed in this area before a clear conclusion can be reached. | c |
| chronic ischemic heart disease unspecified | melatonin may decrease cardiac damage during ischemia-reperfusion. further research is needed in this area before a clear conclusion can be reached. | c |
| circadian rhythm sleep disorder | limited human study is available in this area. present studies and individual cases suggest that melatonin, administered in the evening, may correct circadian rhythm. large, well-designed controlled trials are needed before a stronger recommendation can be made. | c |
| circadian rhythm sleep disorder of nonorganic | there are several studies of melatonin use in people who work irregular shifts, such as emergency room personnel. modest improvements have been reported when melatonin was used with bright light. results are mixed. additional research is necessary before a clear conclusion can be drawn. | c |
| circadian rhythm sleep disorder, delayed sleep phase type | delayed sleep phase syndrome is a condition that results in delayed sleep onset despite normal sleep architecture and sleep duration. although these results are promising, additional research with larger studies is needed before a stronger recommendation can be made. | b |
| circadian rhythm sleep disorder, jet lag type | several human trials suggest that melatonin taken by mouth, started on the day of travel (close to the target bedtime at the destination) and continued for several days, reduces the number of days required to establish a normal sleep pattern, diminishes the time it takes to fall asleep ("sleep latency"), improves alertness, and reduces daytime fatigue. although these results are compelling, the majority of studies have had problems with their designs and reporting, and some trials have not found | a |
| critical illness myopathy | melatonin may improve sleep disturbances in patients in the icu. further studies are needed before a clear conclusion can be reached. | c |
| diabetes mellitus without mention of complication | melatonin when used with zinc may improve glycemic control in patients with poor response to metformin. more evidence is needed before a conclusion can be made. | c |
| disturbance of skin sensation | melatonin premedication may decrease the amount of standard anesthesia regimens needed. additional research is needed before a strong recommendation can be made. | c |
| dyspepsia and other specified disorders of function of stomach | several studies show that treatment with melatonin may be useful in patients with functional dyspepsia. well-designed clinical trials are required before a strong recommendation can be made. | c |
| epilepsy unspecified | the role of melatonin in seizure disorders is controversial. better evidence is needed in this area before a clear conclusion can be drawn regarding the safety or effectiveness of melatonin. | c |
| fever, unspecified | study results have been inconsistent, with some studies reporting benefits on sleep latency and subjective sleep quality, and other research finding no benefits. most studies have been small and not rigorously designed or reported. better research is needed before a firm conclusion can be drawn.notably, several studies in elderly individuals with insomnia provide preliminary evidence of benefits on sleep latency (discussed above). | c |
| glaucoma | it has been theorized that high doses of melatonin may increase intraocular pressure and the risk of glaucoma, age-related maculopathy and myopia, or retinal damage. however, there is preliminary evidence that melatonin may actually decrease intraocular pressure in the eye and delay macular degeneration, and it has been suggested as a possible therapy for glaucoma. additional study is necessary in this area. patients with glaucoma taking melatonin should be monitored by a healthcare | c |
| headache | several small studies have examined the possible role of melatonin in preventing various forms of headache, including migraine, cluster and tension-type headache, and other headache syndromes (in people who suffer from regular headaches). limited initial research suggests possible benefits in all three types of headache, although well-designed controlled studies are needed before a firm conclusion can be drawn. | c |
| human immunodeficiency virus (hiv) disease | there is a lack of well-designed scientific evidence to recommend for or against the use of melatonin as a treatment for aids. melatonin should not be used in place of more proven therapies, and patients with hiv/aids should be treated under the supervision of a medical doctor. | c |
| irritable bowel syndrome | melatonin has shown some beneficial effects in patients with ibs. further study using a larger number of patients is needed before a recommendation can be made. | c |
| neoplasms | there are several early-phase and controlled human trials of melatonin in patients with various advanced stage malignancies, including brain, breast, colorectal, gastric, liver, lung, pancreatic, and testicular cancer, as well as lymphoma, melanoma, renal cell carcinoma, and soft-tissue sarcoma. currently, no clear conclusion can be drawn in this area. there is not enough definitive scientific evidence to discern if melatonin is beneficial against any type of cancer, whether it increases (or | c |
| nocturia | melatonin may have beneficial effects for nocturia in the elderly. further research is needed to before a recommendation can be made. | c |
| other and unspecified noninfectious gastroenteritis and colitis | based on preliminary study, melatonin is a promising therapeutic agent for ibd. further research is needed before a firm recommendation can be made. | c |
| other sleep disturbances | multiple human studies have measured the effects of melatonin supplements on sleep in healthy individuals. a wide range of doses has been used often taken by mouth 30 to 60 minutes prior to sleep time. most trials have been small, brief in duration, and have not been rigorously designed or reported. however, the weight of scientific evidence does suggest that melatonin decreases the time it takes to fall asleep ("sleep latency"), increases the feeling of "sleepiness," and may increase the | b |
| other sleep disturbances | depression can be associated with neuroendocrine and sleep abnormalities, such as reduced time before dream sleep (rem latency). melatonin has been suggested for the improvement of sleep patterns in patients with depression, although research is limited in this area. further studies are needed before a clear conclusion can be reached. | c |
| other sleep disturbances | several published cases report improvements in sleep patterns in young people with damage to the pineal gland area of the brain due to tumors or surgery. due to the rarity of such disorders, controlled trials may not be possible. consideration of melatonin in such patients should be under the direction of a qualified healthcare provider. | c |
| other specified cerebral degenerations in childhood | rett syndrome is a presumed genetic disorder that affects female children, characterized by decelerated head growth and global developmental regression. there is limited study of the possible role of melatonin in improving sleep disturbance associated with rett syndrome. further research is needed before a firm recommendation can be made in this area. | c |
| parkinson's disease | due to very limited study to date, a recommendation cannot be made for or against the use of melatonin in parkinsonism or parkinson's disease. better-designed research is needed before a firm conclusion can be reached in this area. | c |
| periodic limb movement disorder | there is very limited study to date for the use of melatonin as a treatment in periodic limb movement disorder. better-designed research is needed before a recommendation can be made in this area. | c |
| pure hypercholesterolemia | one clinical trial found that melatonin when used with zinc and the diabetes drug, metformin, may improve diabetes-related complications such as impaired lipid profile. however, there is also evidence that melatonin will increase cholesterol levels. more research is needed to clarify mixed results. | c |
| rem sleep behavior disorder | limited case reports describe benefits in patients with rem sleep behavior disorder who receive melatonin. however, better research is needed before a clear conclusion can be drawn. | c |
| sarcoidosis | beneficial effects have been reported in people with chronic sarcoidosis who took melatonin. additional research is needed before a recommendation can be made. | c |
| subacute dyskinesia due to drugs | tardive dyskinesia (td) is a serious potential side effect of antipsychotic medications, characterized by involuntary muscle movements. limited small studies of melatonin use in patients with td report mixed findings. additional research is necessary before a clear conclusion can be drawn. | c |
| thrombocytopenia unspecified | increased platelet counts after melatonin use have been observed in patients with decreased platelets due to cancer therapies (several studies reported by the same author). stimulation of platelet production (thrombopoeisis) has been suggested but not clearly demonstrated. additional research is necessary in this area before a clear conclusion can be drawn. | c |
| tinnitus | melatonin use has been associated with improvement of tinnitus and sleep. however, additional research is needed before a conclusion can be made. | c |
| transient disorder of initiating or maintaining sleep | several human studies report that melatonin taken by mouth before bedtime decreases the amount of time it takes to fall asleep ("sleep latency") in elderly individuals with insomnia. improved sleep quality and morning alertness has also been reported. however, most studies have not been high quality in their designs and some research has found limited or no benefits. the majority of trials have been brief in duration (several days long), and long-term effects are not known. | b |
| unspecified adverse effect of other drug, medicinal and biological substance | several human trials have examined the effects of melatonin on side effects associated with various cancer chemotherapies. although these early reported benefits are promising, high-quality controlled trials are necessary before a clear conclusion can be reached in this area. it remains unclear if melatonin safely reduces side effects of various chemotherapies without altering effectiveness. | c |
| unspecified essential hypertension | several controlled studies in patients with high blood pressure report small reductions blood pressure when taking melatonin by mouth (orally) or inhaled through the nose (intranasally). specifically, nocturnal high blood pressure may improve with melatonin use. better-designed research is necessary before a firm conclusion can be reached. | c |
| unspecified persistent mental disorders due to conditions classified elsewhere | there is not enough evidence to support the use of melatonin in managing the cognitive and non-cognitive conditions of dementia. | c |
| unspecified sleep disturbance | there is limited study of melatonin for improving sleep latency (time to fall asleep) in patients with schizophrenia. improvements in quality and depth of sleep, reduced number of nighttime awakenings, and increased duration of sleep without producing morning hangover has also been reported in schizophrenic patients with insomnia. further research is needed in this area before a clear conclusion can be reached. | c |
