Sleep-facilitating effect of exogenous melatonin in healthy young men and women is circadian-phase dependent
Sleep-facilitating effect of exogenous melatonin in healthy young men and women is circadian-phase dependent
复制标题
DOI：
10.1093/sleep/29.5.609
复制
发表时间：
2006-05-01
期刊：
影响因子：
5.6
通讯作者：
Czeisler, Charles A.
中科院分区：
文献类型：
--
作者：
Wyatt, James K.;Dijk, Derk-Jan;Czeisler, Charles A.
研究目的：探讨生理和药理剂量的外源性褪黑素对睡眠潜伏期和睡眠效率的影响。设计：双盲、安慰剂对照、平行分组设计，采用27天强制脱同步法，20小时为一个预定的睡眠-唤醒周期。背景：一个综合临床研究中心的私人套房，在没有每日时间信息的情况下。受试者：36名健康，18-30岁，男性(n=21)和女性(n=15)。干预：在强制脱同步期间，每6.67小时睡眠发作前30分钟给予口服褪黑素(0.3 mg或5.0 mg)或外观相同的安慰剂。测量和结果：两种剂量的褪黑素都能改善多导睡眠图确定的睡眠效率，从安慰剂组的77%提高到内源性褪黑素缺乏的昼夜节律睡眠发作的83%。然而，这仍然低于在昼夜睡眠期间观察到的88%的平均睡眠效率，当时存在内源性褪黑素。褪黑素对入睡时间和核心体温没有显著影响。褪黑素似乎在整个研究中保持了疗效，对慢波睡眠或快速眼动睡眠的百分比没有显著影响。结论：外源性褪黑素给药具有昼夜相依赖的催眠特性，允许改善在昼夜与内源性褪黑素分泌不同的睡眠巩固。结果支持这样的假设，即外源性和内源性褪黑素都减弱了来自昼夜节律系统的唤醒驱动。
Study Objectives: To investigate the effects of a physiologic and a pharmacologic dose of exogenous melatonin on sleep latency and sleep efficiency in sleep episodes initiated across a full range of circadian phases.Design: Double-blind placebo-controlled parallel-group design in a 27-day forced desynchrony paradigm with a 20-hour scheduled sleep-wake cycle.Setting: Private suite of a general clinical research center, in the absence of time-of-day information.Subjects: Thirty-six healthy, 18- to 30-year-old, men (n = 21) and women (n = 15).Interventions: Oral melatonin (0.3 mg or 5.0 mg) or identical-appearing placebo was administered 30 minutes prior to each 6.67-hour sleep episode during forced desynchrony.Measurements and Results: Both doses of melatonin improved polysomnographically determined sleep efficiency from 77% in the placebo group to 83% for sleep episodes occurring during circadian phases when endogenous melatonin was absent. However, this remained below the average sleep efficiency of 88% observed during sleep episodes scheduled during the circadian night, when endogenous melatonin was present. Melatonin did not significantly affect sleep initiation or core body temperature. Melatonin appeared to maintain efficacy across the study and did not significantly affect percentages of slow-wave sleep or rapid eye movement sleep.Conclusions: Exogenous melatonin administration possesses circadian-phase-dependent hypnotic properties, allowing for improved consolidation of sleep that occurs out of phase with endogenous melatonin secretion during the circadian night. The results support the hypothesis that both exogenous and endogenous melatonin attenuate the wake-promoting drive from the circadian system.