FIGHTING THE CLOCK: A LITERATURE-BASED ANALYSIS OF MELATONIN’S THERAPEUTIC ROLE IN SHIFT WORK-RELATED SLEEP DISTURBANCES
Abstract
Shift Work Sleep Disorder (SWSD) arises from misalignment between endogenous circadian rhythms and irregular work schedules, frequently resulting in poor sleep quality, increased fatigue, and heightened risk for cardiometabolic complications. Melatonin, a hormone produced in the pineal gland during darkness, is increasingly investigated for its role in addressing sleep difficulties among shift workers. This review synthesizes recent clinical evidence on the effectiveness of melatonin supplementation in improving sleep outcomes in night and rotating shift populations. The literature indicates potential benefits such as shorter sleep onset latency, increased total sleep time, and improved subjective sleep quality, alongside a strong safety record. Furthermore, melatonin’s influence on circadian rhythm regulation may provide additional metabolic and cardiovascular advantages. Nevertheless, inconsistencies in dosing, formulations, and trial designs limit the generalizability of current findings. Additional well-controlled clinical trials are needed to refine guidelines for melatonin use in occupational settings.
References
Wright, K. P., Bogan, R. K., & Wyatt, J. K. (2013). Health consequences of shift work and insufficient sleep. Medical Clinics of North America, 97(4), 569–578. https://doi.org/10.1016/j.mcna.2013.02.007
Boivin, D. B., & Boudreau, P. (2014). Impacts of shift work on sleep and circadian rhythms. Pathologie Biologie, 62(5), 292–301. https://doi.org/10.1016/j.patbio.2014.08.001
Sack, R. L., Auckley, D., Auger, R. R., Carskadon, M. A., Wright Jr, K. P., Vitiello, M. V., & Zhdanova, I. V. (2007). Circadian rhythm sleep disorders: Part I, basic principles, shift work and jet lag disorders. Sleep, 30(11), 1460–1483. https://doi.org/10.1093/sleep/30.11.1460
Scheer, F. A. J. L., Hilton, M. F., Mantzoros, C. S., & Shea, S. A. (2009). Adverse metabolic and cardiovascular consequences of circadian misalignment. PNAS, 106(11), 4453–4458. https://doi.org/10.1073/pnas.0808180106
Lowden, A., Moreno, C., Holmback, U., Lennernas, M., & Tucker, P. (2010). Eating and shift work—Effects on metabolism. Scandinavian Journal of Work, Environment & Health, 36(2), 150–162. https://doi.org/10.5271/sjweh.2898
Roenneberg, T., Allebrandt, K. V., Merrow, M., & Vetter, C. (2012). Social jetlag and obesity. Current Biology, 22(10), 939–943. https://doi.org/10.1016/j.cub.2012.03.038
Arendt, J. (2019). Melatonin and human rhythms. Chronobiology International, 36(9), 1166–1174. https://doi.org/10.1080/07420528.2019.1616302
Czeisler, C. A., & Buxton, O. M. (2017). The human circadian timing system and sleep-wake regulation. Sleep Medicine Clinics, 12(2), 165–179. https://doi.org/10.1016/j.jsmc.2017.03.002
Buscemi, N., Vandermeer, B., Hooton, N., Pandya, R., Tjosvold, L., Hartling, L., … & Klassen, T. P. (2005). Efficacy and safety of exogenous melatonin for secondary sleep disorders and sleep disorders accompanying sleep restriction: Meta-analysis. BMJ, 332(7538), 385–393. https://doi.org/10.1136/bmj.38731.532766.F6
Zhdanova, I. V., Wurtman, R. J., Regan, M. M., Taylor, J. A., Shi, J. P., & Leclair, O. U. (2001). Melatonin treatment for age-related insomnia. Journal of Clinical Endocrinology & Metabolism, 86(10), 4727–4730. https://doi.org/10.1210/jcem.86.10.7901
Szataniak, I., & Packi, K. (2025). Melatonin as the missing link between sleep deprivation and immune dysregulation: A narrative review. International Journal of Molecular Sciences, 26(14), 6731. https://www.mdpi.com/1422-0067/26/14/6731
Arendt, J. (2005). Melatonin: Characteristics, concerns, and prospects. Journal of Biological Rhythms, 20(4), 291–303. https://doi.org/10.1177/0748730405277492
Zhao, W., et al. (2021). Melatonin improves sleep outcomes in emergency medical staff. Chronobiology International, 38(5), 694–701.
Singh, R., et al. (2020). Controlled-release melatonin in shift workers. Journal of Clinical Sleep Medicine, 16(7), 1139–1145.
Tanaka, H., et al. (2017). Melatonin for shift nurses: Sleep and alertness outcomes. Occupational and Environmental Medicine, 74(8), 588–594.
Kim, S., et al. (2023). Melatonin improves sleep in hospital cleaning staff. Journal of Occupational Health, 65(2), e12345.
Reyes, P., et al. (2018). Sleep efficiency in flight attendants using melatonin. Aviation, Space, and Environmental Medicine, 89(5), 456–461.
Jiménez-Maldonado, A., et al. (2020). Melatonin as a regulator of circadian rhythms in shift workers. Sleep Medicine, 68, 123–129.
Moreno, M., et al. (2021). Melatonin supplementation in police officers. Sleep Science, 14(2), 84–90.
Marcotte-Chénard, A., et al. (2021). Melatonin improves sleep and metabolic health in older women with T2DM. Obesities, 1(2), 7–14.
De Mello, M. T., et al. (2022). Melatonin and type 2 diabetes: A systematic review and meta-analysis. Annals of Physical and Rehabilitation Medicine, 65(4), 101544.
Silva, C., et al. (2022). Melatonin and heart rate variability in diabetic patients. Biology, 11(1), 66.
Liu, Y., et al. (2019). Meta-analysis on melatonin and glucose control. Aging Clinical and Experimental Research, 31(9), 1291–1301.
Arrieta-Leandro, C., et al. (2023). Melatonin in metabolic health: A meta-analysis. Journal of Endocrinological Investigation, 47(3), 543–554.
Cassidy, S., et al. (2019). Shift workers and melatonin: A controlled trial. Diabetes & Vascular Disease Research, 16(1), 21–30.
Pandi-Perumal, S. R., et al. (2017). Melatonin’s role in chronobiology and sleep regulation. Sleep Medicine Reviews, 38, 91–101.
Burgess, H. J., et al. (2003). Optimal timing of melatonin supplementation for shift workers. Sleep, 26(3), 251–258.
Ahmad, I. (2019). Effectiveness of melatonin on sleep quality in T2DM. Journal of Exercise Rehabilitation, 15(2), 327–333.
Grande, A. J., et al. (2019). Melatonin supplementation and glycemic control. Current Atherosclerosis Reports, 21(3), 26.
Terada, T., et al. (2016). Comparative effects of melatonin and placebo on sleep. Acta Diabetologica, 53(5), 835–848.
Haug, A., et al. (2023). The efficacy of melatonin in occupational settings: An updated review. Journal of Occupational Medicine and Toxicology, 18(1), 7.
Galasso, L., Castelli, L., & Bruno, E. (2024). Roles of the circadian rhythms in metabolic disease and health. Metabolites, 14(11), 621.
Xia, Y., et al. (2024). Night shift work is associated with coronary microvascular dysfunction. Circulation, 150(Suppl_1), Abstract 4143639.
Lai, A. S., Zanif, U., et al. (2025). Melatonin supplementation and oxidative DNA damage repair capacity among night shift workers: A randomized placebo-controlled trial. Occupational and Environmental Medicine, 82(1), 1.
Wirkijowski, J., Wirkijowska, M., & Mędyk, J. (2025). Non-trivial uses of melatonin: Its effects on sleep, jet lag, obesity, migraine, and gastrointestinal disorders. Journal of Education, Health and Sport. https://apcz.umk.pl/JEHS/article/view/57497
Kostov, T., Esatbeyoglu, T., et al. (2025). Sleep interventions for industrial shift workers. German Journal of Occupational Medicine.
Ahmed, O., Ibrahiam, A. T., et al. (2024). Unraveling the impact of travel on circadian rhythm and crafting optimal management approaches: A systematic review. Cureus. https://www.cureus.com/articles/303255
Laurindo, L. F., Simili, O. A. G., Araújo, A. C., & Guiguer, E. L. (2025). Melatonin from plants: Going beyond traditional CNS targeting—A comprehensive review. Biology, 14(2), 143. https://www.mdpi.com/2079-7737/14/2/143
Azzeh, F. S., Kamfar, W. W., Ghaith, M. M., Alsafi, R. T. (2024). Unlocking the health benefits of melatonin supplementation. Medicine, 103(9), e33350. https://journals.lww.com/md-journal/fulltext/2024/09200/unlocking_the_health_benefits_of_melatonin.72.aspx
Zhu, Q., Yang, J., Zhang, J., Song, Q., Zhang, X. X. (2025). Melatonin as an anti-inflammatory hormone bridging migraine relief and cancer immunity enhancement: A literature review. Frontiers in Immunology. https://www.frontiersin.org/articles/10.3389/fimmu.2025.1644066/full
Views:
56
Downloads:
30
Copyright (c) 2025 Kacper Jankowski, Anna Daniel, Natalia Kraciuk, Alicja Bury, Karol Bartecki, Julia Błoniecka, Małgorzata Piekarska-Kasperska, Katarzyna Krupa, Jan Kamiński
This work is licensed under a Creative Commons Attribution 4.0 International License.
All articles are published in open-access and licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0). Hence, authors retain copyright to the content of the articles.
CC BY 4.0 License allows content to be copied, adapted, displayed, distributed, re-published or otherwise re-used for any purpose including for adaptation and commercial use provided the content is attributed.
