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Abolished circadian rhythm of melatonin secretion in sedated and artificially ventilated intensive care patients

Olofsson, K; Alling, Christer LU ; Lundberg, Dag LU and Malmros, C (2004) In Acta Anaesthesiologica Scandinavica 48(6). p.679-684
Abstract
Background: Sleep disturbance is common in intensive care patients. Aside from its unpleasantness, there is a correlation with intensive care unit (ICU) syndrome/delirium. Reasons for sleep deprivation appear to be multifactorial, including the underlying illness, an acute superimposed disturbance, medications, and the ICU environment itself. There are reasons to believe that alterations of the 'biological clock' might contribute. Melatonin secretion is one reflection of this internal sleep/wake mechanism. Melatonin levels are normally high during the night and low during daytime, being suppressed by bright light. Methods: Melatonin levels in blood and urine were studied over 3 consecutive days in eight critically ill patients during deep... (More)
Background: Sleep disturbance is common in intensive care patients. Aside from its unpleasantness, there is a correlation with intensive care unit (ICU) syndrome/delirium. Reasons for sleep deprivation appear to be multifactorial, including the underlying illness, an acute superimposed disturbance, medications, and the ICU environment itself. There are reasons to believe that alterations of the 'biological clock' might contribute. Melatonin secretion is one reflection of this internal sleep/wake mechanism. Melatonin levels are normally high during the night and low during daytime, being suppressed by bright light. Methods: Melatonin levels in blood and urine were studied over 3 consecutive days in eight critically ill patients during deep sedation and mechanical ventilation. Sedation was assessed with the sedation-agitation (SAS) scale and bispectral index (BIS) monitor. Results: The circadian rhythm of melatonin release was abolished in all but one patient, who recovered much more quickly than the others. There was no correlation between melatonin levels and levels of sedation. Conclusions: This study indicates that dyssynchronization of the melatonin secretion rhythm is common in critically ill and mechanically ventilated patients. It could be hypothesized that an impairment of the melatonin rhythm may play a role in the development of sleep disturbances and delirium in intensive care patients, and that melatonin supply could reduce the incidence of these phenomena. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
sleep, melatonin, intensive care, ICU syndrome, circadian rhythm, critical illness
in
Acta Anaesthesiologica Scandinavica
volume
48
issue
6
pages
679 - 684
publisher
Wiley-Blackwell
external identifiers
  • wos:000221967500002
  • pmid:15196098
  • scopus:3042570072
ISSN
0001-5172
DOI
10.1111/j.0001-5172.2004.00401.x
language
English
LU publication?
yes
id
7c0ba6e6-9b7b-44e2-8848-d62f09d2a88e (old id 275755)
date added to LUP
2007-10-29 11:01:17
date last changed
2017-12-10 03:49:20
@article{7c0ba6e6-9b7b-44e2-8848-d62f09d2a88e,
  abstract     = {Background: Sleep disturbance is common in intensive care patients. Aside from its unpleasantness, there is a correlation with intensive care unit (ICU) syndrome/delirium. Reasons for sleep deprivation appear to be multifactorial, including the underlying illness, an acute superimposed disturbance, medications, and the ICU environment itself. There are reasons to believe that alterations of the 'biological clock' might contribute. Melatonin secretion is one reflection of this internal sleep/wake mechanism. Melatonin levels are normally high during the night and low during daytime, being suppressed by bright light. Methods: Melatonin levels in blood and urine were studied over 3 consecutive days in eight critically ill patients during deep sedation and mechanical ventilation. Sedation was assessed with the sedation-agitation (SAS) scale and bispectral index (BIS) monitor. Results: The circadian rhythm of melatonin release was abolished in all but one patient, who recovered much more quickly than the others. There was no correlation between melatonin levels and levels of sedation. Conclusions: This study indicates that dyssynchronization of the melatonin secretion rhythm is common in critically ill and mechanically ventilated patients. It could be hypothesized that an impairment of the melatonin rhythm may play a role in the development of sleep disturbances and delirium in intensive care patients, and that melatonin supply could reduce the incidence of these phenomena.},
  author       = {Olofsson, K and Alling, Christer and Lundberg, Dag and Malmros, C},
  issn         = {0001-5172},
  keyword      = {sleep,melatonin,intensive care,ICU syndrome,circadian rhythm,critical illness},
  language     = {eng},
  number       = {6},
  pages        = {679--684},
  publisher    = {Wiley-Blackwell},
  series       = {Acta Anaesthesiologica Scandinavica},
  title        = {Abolished circadian rhythm of melatonin secretion in sedated and artificially ventilated intensive care patients},
  url          = {http://dx.doi.org/10.1111/j.0001-5172.2004.00401.x},
  volume       = {48},
  year         = {2004},
}