MELATONIN-RESPONSIVE HEADACHE IN DELAYED SLEEP PHASE SYNDROME - PRELIMINARY-OBSERVATIONS

The occurrence of headache and its change after treatment with melaton in 5 mg were studied in 30 patients with delayed sleep phase syndrome. The medication was taken 5 hours before the endogenous nocturnal plas ma melatonin concentration had reached 10 pg/mL. Three women (aged 14, 14, and 23 years) suffered from chronic tension-type headache. Their headache disappeared within 2 weeks after the start of treatment with melatonin. One 54-year-old man suffered from disabling migraine attack s without aura, twice a week. After starting melatonin treatment, only three migraine attacks were reported in 12 months. Ever since his 40s , a 60-year-old man complained of cluster headache episodes lasting ab out 2 months, twice a year. In the year since starting melatonin treat ment, only one 5-day cluster episode occurred. Nocturnal melatonin sec retion in the patients with delayed sleep phase syndrome and headache did not differ significantly from that in the patients with the sleep disorder but without headache. Melatonin may be helpful in patients wi th headache who are suffering from delayed sleep phase syndrome. Its e ffectiveness may be doe to modification of vascular and nociceptive sy stems or to its chronobiological action which adjusts the patient's bi ological clock to his/her life-style.