[Effective melatonin therapy in a case of Machado-Joseph disease with insomnia].

The effects of melatonin (MLT) therapy on insomnia and serum MLT concentration were studied in a 44-year-old man with Machado-Joseph disease. He suffered from insomia since age 41, and could not sleep well, despite that he was given many kinds of hypnotics. He showed neither noctural central apnea, inspirative stridor, restless leg syndrome, REM without atonia, nor noctural polyuria, all of which are known to cause insomnia in spinocerebellar degeneration. The peak serum level of MLT was low, 9.2 pg/ml. He was administered 9 mg of MLT p.o. at 8 p.m., and it's peak noctural level elevated to 7,000 pg/ml, and this alleviated his intractable insomnia. Our experience indicate that the MLT could be effective for insomnia in MJD which relates to low MLT concentration.