 In clinical studies low doses 1-5mg of exogenous melatonin are effective in normalising the sleep-wake cycle in patients with sepsis. Our in vitro studies in a human endothelial cell model of sepsis show that higher dose melatonin and its metabolites are equally effective. In a rat model of sepsis melatonin reduces oxidative damage. The dose needed for antioxidant actions is considerably higher than that used in sleep-wake cycle studies, but the actual dose required is unclear. In some studies melatonin has been administered to patients at larger doses. Melatonin 10mgday decreased interleukin-6 IL-6 levels in patients with cancer; 300mgday decreased oxidative stress in patients with amyotrophic lateral sclerosis. In children with muscular dystrophy, 70mgday melatonin reduced cytokines and lipid peroxidation. Melatonin is also likely to be beneficial in sepsis. 