Elevated serum melatonin is associated with the nocturnal worsening of asthma

E. Rand Sutherland, Misoo C. Ellison, Monica Kraft, Richard J. Martin

Research output: Contribution to journalArticlepeer-review

67 Scopus citations


Background: Increased airway inflammation at night contributes to the nocturnal worsening of asthma. In vitro studies have shown exogenous melatonin to be pro-inflammatory in asthma, but it is unknown whether endogenous melatonin levels are a controller of airway inflammation in nocturnal asthma. Objective: Our aim was to determine 24-hour patterns of serum melatonin and their relationship to overnight decline in physiology in subjects with nocturnal asthma, non-nocturnal asthma, and in healthy controls. Methods: Observational study of pulmonary physiology and melatonin levels in patients with nocturnal asthma (n = 7), non-nocturnal asthma (n = 13), and healthy controls (n = 11). Subjects maintained a constant sleep-wake regimen for 7 days. On day 8, serum melatonin was measured every 2 hours by radioimmunoassay and analyzed by cosinor modeling. The correlation between serum melatonin levels and overnight change in spirometry was evaluated by Spearman's rank correlation analysis. Results: In subjects with nocturnal asthma, peak melatonin levels were significantly elevated compared with healthy controls (67.6 ± 5.0 pg/mL versus 53.5 ± 4.0 pg/mL, P = .03). Melatonin acrophase was delayed in nocturnal asthma (02:54 versus 01:58 in healthy controls, P = .003, and 02: 15 in non-nocturnal asthma, P = .01). In subjects with nocturnal asthma, increasing melatonin levels were significantly and inversely correlated with overnight change in FEV1 (r = -.79, P = .04), a relationship that was not observed in non-nocturnal asthma or healthy controls. Conclusions: Nocturnal asthma is associated with elevation and phase delay of peak serum melatonin levels. Elevated melatonin levels might contribute to the pathogenesis of nocturnal asthma.

Original languageEnglish (US)
Pages (from-to)513-517
Number of pages5
JournalJournal of Allergy and Clinical Immunology
Issue number3
StatePublished - Sep 1 2003


  • Circadian rhythm
  • Inflammation
  • Melatonin

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology


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