State of Oregon

Oregon Health & Science University

Robert L Sack

Alfred J Lewy

James W Ayres

Keith A Parrott

A method for treating circadian rhythm phase disorders is described. The invention provides methods to specifically advance or delay the phase of certain circadian rhythms in humans. The disclosed methods relate to the administration of melatonin at times determined with relation to the time of dim light endogenous melatonin onset. Embodiments capable of alleviating the effects of jet lag, winter depression and shift-work sleep disturbance are provided.

Methods for treating circadian rhythm phase disturbances

A method for treating circadian rhythm disorders is described. The method involves the administration of melatonin, melatonin agonists or compounds that stimulate endogenous melatonin production so that the durations of the effective plasma concentrations of melatonin, melatonin agonists or compounds that stimulate endogenous melatonin production overlap with onset or offset of pre-treatment endogenous melatonin production, to provide a circadian-rhythm phase advance or phase delay, respectively. The methods of the invention also provide for concentration and/or duration of the effective plasma concentrations of melatonin, melatonin agonists or compounds that stimulate endogenous melatonin production to be greater in the time interval between about 8 hours before the dim light endogenous melatonin onset (DLMO) to about 4 hours after DLMO than in the time interval from about 4 hours after DLMO to about 8 hours before DLMO to achieve a circadian-rhythm phase advance. The methods of the invention also provide for concentration and/or duration of the effective plasma concentrations of melatonin, melatonin agonists or compounds that stimulate endogenous melatonin production to be greater in the time interval between about 4 hours after DLMO to about 8 hours before DLMO than in the time interval from about 8 hours before DLMO time to about 4 hours after DLMO to achieve a circadian-rhythm phase delay. In addition, the invention provides methods for regulating a human's exposure to light and dark to prevent or enhance, respectively, the human's endogenous production of melatonin. The use of melatonin antagonists, inverse agonists and melatonin inhibitory compounds such as beta-blockers for achieving a circadian-rhythm phase-shifting effect (opposite to that of melatonin administration) are also provided by the invention. The methods of the invention are illustrated by teachings for use of these methods for alleviating a variety of circadian rhythm-related disorders, including jet lag, winter depression, shift work-related desynchronies and sleep phase disorders.

Methods for treating circadian rhythm disorders

A method for treating circadian rhythm phase disorders is described. The invention provides methods to specifically advance or delay the phase of certain circadian rhythms in humans. The disclosed methods relate to the administration of melatonin at times determined with relation to the time of dim light endogenous melatonin onset. Embodiments capable of alleviating the effects of jet lag, winter depression and shiftwork sleep disturbance are provided.

A method for treating circadian rhythm disorders is described. The method involves the administration of melatonin from about 6 hours to about 19 hours prior to when the normal sleep phase should begin, depending on whether a phase advance shift in circadian rhythms or a phase delay shift is desired. This is typically from about 4 hours to about 17 hours prior to the time of endogenous melatonin onset.

Methods of treating circadian rhythm disorders

Methods for treating circadian rhythm disorders and sleep disorders are described. The method involves oral administration of a sustained release composition of melatonin to produce a normal melatonin pattern when the normal pattern has been disrupted or is missing.

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Portland, OR, United States of America

Robert L Sack