Sleeping easier for elderly in pill trial pill

CELIA HALL

Medical Editor

A synthetic version of the "sleep hormone" melatonin has helped a group of elderly patients suffering from chronic insomnia.

Israeli researchers working with 12 men and women aged between 68 and 93 found they could improve their quality of sleep by giving them melatonin replacement therapy in a controlled-release pill.

Melatonin concentrations decrease with age, meaning many elderly people have difficulty getting to sleep and wake often. Melatonin has helped jet-lag sufferers, but short-term experiments on people with chronic insomnia have not shown any benefit.

Professor Nava Zisapel and Dr George Wise, of Tel-Aviv University, say their trial differed from others by first establishing that their patients were melatonin-deficient by measuring night-time urine.

In addition, all their patients had a range of conditions, including heart disease, diabetes and Parkinson's disease, and were on a variety of drugs, including sleeping pills.

In the trial, patients either received melatonin or a placebo over two three-week periods. As well as improving their quality of sleep, some patients were also weaned off sleeping pills.

Writing in The Lancet, Professor Zisapel says insomnia caused by aging and drug side-effects can be alleviated in melatonin-deficient patients.

He urges doctors to first ensure that patients are not suffering from conditions that would affect sleep and then test night-time melatonin levels. "Whenever melatonin deficiency is found, melatonin replacement therapy (preferably with a controlled-release preparation) can be tried for at least three weeks," he says.

tThe type of migraine which has visual or sensory disturbances, called migraine with aura, runs in families, say Danish researchers in the British Medical Journal. Close relatives have four times the risk of migraine with aura but are not more likely to have migraine without aura.