Delirium is a common complication of illness especially among the elderly with serious
sequelae including increased mortality, morbidity and length of stay. This neuropsychiatric
emergency has key features including acute onset, fluctuating level of consciousness, poor
attention and cognitive deficits with a presentation which may include hallucinations and
delusions.
A critical precipitating and maintaining feature of delirium is disrupted sleep. Melatonin is
a widely available natural health product with evidence in normalizing circadian rhythms and
sleep. There is also preliminary evidence that melatonin can be used to prevent the
development of delirium in hospitalized patients. We hypothesize that daily administration of
melatonin (1.5mg) in the evening, beginning at first admission to hospital and continuing for
14 days, will lead to decreased rates of delirium compared to placebo-treated comparison
subjects.