Prediction of melatonin efficacy by pretreatment dim light melatonin onset in children with idiopathic chronic sleep onset insomnia
Prediction of melatonin efficacy by pretreatment dim light melatonin onset in children with idiopathic chronic sleep onset insomnia
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预治疗弱光褪黑素起效预测特发性慢性入睡失眠儿童褪黑素疗效
DOI：
10.1111/j.1365-2869.2005.00451.x
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发表时间：
2005
影响因子：
4.4
通讯作者：
W. Boudewijn Gunning
中科院分区：
文献类型：
--
作者：
K. B. Heijden;M. Smits;E. Someren;W. Boudewijn Gunning
研究表明，褪黑激素治疗对改善失眠症患者的睡眠-觉醒节律有疗效。在健康成人中，相移的方向和幅度取决于相对于昼夜节律系统相位的给药时间。因此，在本研究中，我们调查是否在儿童慢性睡眠发作失眠（SOI）的褪黑激素治疗的疗效在傍晚可以预测从昏暗的光褪黑激素发作（DLMO），昼夜节律系统的相位标记。我们结合了两项先前发表的双盲、随机、安慰剂对照试验的数据，这些试验涉及110名6-12岁的受试者。 在基线时和4周治疗期的第3周（18：00或19：00时给予5 mg褪黑激素或安慰剂），通过活动图估计睡眠，并收集唾液。 主要结局指标为治疗前后昏暗灯光下褪黑激素起效（ΔDLMO）、睡眠起效（ΔSO）、睡眠潜伏期（ΔSL）和总睡眠持续时间（ΔTSD）的变化。与安慰剂相比，褪黑素使DLMO提前+1：12 h（P <0.001），SO提前+0：42 h（P = 0.004），SL减少25 min（P =0.019），TSD无明显变化。 在褪黑激素治疗组中，治疗前DLMO与ΔDLMO [F（1，29）= 7.28，P = 0.012]和ΔSO [F（1，25）= 7.72，P = 0.010]显著相关，但在安慰剂治疗组中不相关。 治疗给药与治疗前DLMO之间的时间间隔（INT）仅与ΔSO显著相关[F（1，26）= 5.40，P = 0.028]。 结果表明，在SOI儿童中，治疗前DLMO越晚，早期晚上褪黑素提前睡眠开始和内源性褪黑素开始的功效越大。
Research has shown efficacy of melatonin treatment to advance sleep–wake rhythms in insomnia. In healthy adults, direction and magnitude of the phase shift depends on the timing of administration relative to the phase position of the circadian system. Therefore, in the present study we investigated whether in children with chronic sleep onset insomnia (SOI) efficacy of melatonin treatment in the early evening could be predicted from dim light melatonin onset (DLMO), a phase marker of the circadian system. We combined data of two previously published double blind, randomized, placebo‐controlled trials in 110 participants, aged 6–12 years. Sleep was actigraphically estimated, and saliva collected, at baseline and in the third week of a 4‐week treatment period with 5 mg melatonin or placebo at 18:00 or 19:00 hours. Primary outcome measures were pre‐ to post‐treatment changes in dim light melatonin onset (ΔDLMO), sleep onset (ΔSO), sleep latency (ΔSL), and total sleep duration (ΔTSD). Melatonin advanced DLMO with +1:12 h (P < 0.001), SO with +0:42 h (P = 0.004), SL decreased with 25 min (P = 0.019), and TSD did not change significantly, as compared with placebo. In the melatonin‐treated group, but not in the placebo‐treated group, pretreatment DLMO was significantly related to ΔDLMO [F(1, 29) = 7.28, P = 0.012] and ΔSO [F(1, 25) = 7.72, P = 0.010]. The time interval between treatment administration and pretreatment DLMO (INT) was only significantly related to ΔSO [F(1,26) = 5.40, P = 0.028]. The results suggest that in children with SOI, the efficacy of early evening melatonin to advance sleep onset and endogenous melatonin onset increases the later the pretreatment DLMO is.
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影响因子：
2.8
作者：
LEWY, AJ;AHMED, S;SACK, RL
通讯作者：
SACK, RL
影响因子：
2.8
作者：
Lewy, AJ;Bauer, VK;Sack, RL
通讯作者：
Sack, RL
影响因子：
5.6
作者：
Sack, RL;Hughes, RJ;Lewy, AJ
通讯作者：
Lewy, AJ
人类下丘脑和垂体中的褪黑激素受体：对褪黑激素的昼夜节律和生殖反应的影响。
DOI：
10.1210/jcem.76.2.8381796
发表时间：
1993
期刊：
The Journal of clinical endocrinology and metabolism
影响因子：
--
作者：
Weaver,DR;Stehle,JH;Stopa,EG;Reppert,SM
通讯作者：
Reppert,SM
影响因子：
5.6
作者：
Carskadon, MA;Wolfson, AR;Seifer, R
通讯作者：
Seifer, R