This article is more than 5 years old. Information may no longer be current.
Oral melatonin may benefit sleep-deprived ICU patients
Click Here to Manage Email Alerts
Melatonin could offer more and better quality sleep compared with earplugs and eye masks after exposure to environments with high levels of noise and light, according to research published in Critical Care.
The findings could have implications for critically ill patients exposed to this type of stimulation in ICUs who experience sleep deprivation and potentially slower recovery times, according to researchers
“Both use of oral melatonin and use of earplugs and eye masks improve sleep quality at different levels, especially melatonin,” Xiu-Ming Xi, MD, of Fuxing Hospital, Capital Medical University, Beijing, said in a news release. “Discomfort from use of earplugs and eye masks might affect sleep quality, which wasn’t reported with melatonin. Therefore, compared to earplugs and eye masks, melatonin showed up the better performance in effectiveness and the tolerance of participants.”
Xi, along with Hua-Wei Huang, also of Fuxing Hospital, and colleagues conducted a two-part study involving 40 healthy participants to determine the impact of simulated ICU noise and light on sleep patterns and explore the effects of the interventions.
In the sleep lab at Fuzhou Children’s Hospital of Fujian province, participants slept a baseline night, followed by 4 nights with simulated ICU noise and light by crossover design. Next, participants were randomly assigned to four groups — no sleep aid; placebo once daily; use of earplugs and eye masks; 1-mg fast-release melatonin before bedtime — and continued to sleep in the simulated ICU.
The researchers measured melatonin levels hourly through blood samples, and sleep quality through polysomnography that showed brain activity, eye movement and muscle tension. Perceived sleep quality and anxiety also were self-rated.
Sleep patterns were generally disturbed by the simulated ICU exposure, with participants experiencing shorter total sleep time and rapid eye movement sleep, longer sleep onset latency, more light sleep and awakening, poorer subjective sleep quality, higher anxiety and lower serum melatonin (P < .05).
The group with earplugs and eye masks had less awakening and shorter sleep onset latency (P < .05). The group receiving melatonin had longer total and rapid eye movement sleep, along with shorter sleep onset latency (P < .05).
Participants had fewer awakenings with melatonin compared with earplugs and eye masks (P = .004). Both groups experienced improved perceived sleep quality and anxiety level (P = .00), with perceived sleep quality better with melatonin (P = .01).
Serum melatonin levels were lower with ICU simulation at every time point compared with baseline. The average maximal serum melatonin concentration in participants receiving melatonin was greater than other groups (P < .001).
“Future studies with larger numbers and greater diversity of participants would likely support these recommendations,” the researchers wrote. “Finally, although no adverse effects related to the oral melatonin were observed in our healthy subjects during the study period, the potential safety issues related to melatonin administration in ICU patients need to be considered.” – by Allegra Tiver
Disclosure: The researchers report no relevant financial disclosures.
Click Here to Manage Email Alerts