Melatonin, sleep, and circadian rhythms

Scheer, Frank A.J.L.; Czeisler, Charles A.

doi:10.1016/j.smrv.2004.11.004

Cited by 132 publications

(82 citation statements)

References 41 publications

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“…It is generally accepted that melatonin administered during the day, when its endogenous levels are low, has somnogenic properties (10,22). When used near the time of habitual sleep, melatonin has produced less consistent results.…”

Section: Discussionmentioning

confidence: 99%

“…Moreover, peak plasma levels of melatonin and cGMP show a positive correlation with sleepiness, pointing to an involvement of cGMP in melatonin hypnotic action (31). It has also been suggested that melatonin may act to facilitate sleep by inhibiting the circadian drive for waking that comes from the suprachiasmatic nucleus (10). This is supported by evidence from studies in both day-active animals (32) and humans (33) that the circadian pacemaker promotes wakefulness at certain times of day, together with evidence that neuronal firing of the mammalian suprachiasmatic nucleus is inhibited by suprachiasmatic nucleus Mel 1a receptor-specific melatonin binding (34).…”

Section: Discussionmentioning

confidence: 99%

“…It plays an important role in the regulation of human circadian rhythms and may have sleep-inducing activity in humans (10). There is also considerable evidence that melatonin has immunomodulatory and anti-oxidant properties (11).…”

Section: Introductionmentioning

confidence: 99%

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Effect of melatonin administration on subjective sleep quality in chronic obstructive pulmonary disease

Nunes

Mota

Machado

et al. 2008

Braz J Med Biol Res

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Disturbed sleep is common in chronic obstructive pulmonary disease (COPD). Conventional hypnotics worsen nocturnal hypoxemia and, in severe cases, can lead to respiratory failure. Exogenous melatonin has somnogenic properties in normal subjects and can improve sleep in several clinical conditions. This randomized, double-blind, placebo-controlled study was carried out to determine the effects of melatonin on sleep in COPD. Thirty consecutive patients with moderate to very severe COPD were initially recruited for the study. None of the participants had a history of disease exacerbation 4 weeks prior to the study, obstructive sleep apnea, mental disorders, current use of oral steroids, methylxanthines or hypnotic-sedative medication, nocturnal oxygen therapy, and shift work. Patients received 3 mg melatonin (N = 12) or placebo (N = 13), orally in a single dose, 1 h before bedtime for 21 consecutive days. Sleep quality was assessed by the Pittsburgh Sleep Quality Index (PSQI) and daytime sleepiness was measured by the Epworth Sleepiness Scale. Pulmonary function and functional exercise level were assessed by spirometry and the 6-min walk test, respectively. Twenty-five patients completed the study protocol and were included in the final analysis. Melatonin treatment significantly improved global PSQI scores (P = 0.012), particularly sleep latency (P = 0.008) and sleep duration (P = 0.046). No differences in daytime sleepiness, lung function and functional exercise level were observed. We conclude that melatonin can improve sleep in COPD. Further long-term studies involving larger number of patients are needed before melatonin can be safely recommended for the management of sleep disturbances in these patients.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Effect of melatonin administration on subjective sleep quality in chronic obstructive pulmonary disease

Nunes

Mota

Machado

et al. 2008

Braz J Med Biol Res

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“…Melatonin concentrations also depend on the duration of sleep. 4,5 This might explain the differences in melatonin concentrations among studies that applied the same method for serum melatonin analysis. The values reported by Hernandez et al 24 were lower than those in our study, but also the total sleep time of the patients was shorter than that in our study (mean [SD], 274 [61] min vs 343 [57] min, respectively).…”

Section: Methodsmentioning

confidence: 99%

Treatment with continuous positive airway pressure and diurnal and nocturnal serum melatonin concentration in patients with obstructive sleep apnea

Barnaś¹,

Maskey-Warzęchowska²,

Bielicki³

et al. 2017

Polish Archives of Internal Medicine

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ORIGINAL ARTICLE CPAP treatment and serum melatonin in OSA 589 models and humans have shown that melatonin secretion is strongly related to sleep, and individuals with decreased melatonin levels suffer from sleep disturbances and insomnia. This refers to elderly patients (as melatonin concentrations tend to fall with age), night-shift workers with an exogenously disrupted sleep-wake rhythm, individuals who had undergone pinealectomy, and others.1,2,10 In patients with primary insomnia, exogenous melatonin decreases sleep onset latency, increases total sleep time, and improves sleep quality. 11,12 Melatonin also effectively reduces jet INTRODUCTION Melatonin is a serotonin-derived hormone secreted by the pineal gland in a cyclic manner. 1 It has diverse activities and regulates numerous physiological processes in mammals, including the sleep-wake rhythm, sexual maturation, reproduction, and aging. It also has antioxidant, oncostatic, and immunomodulative properties.1-3 Its release responds to the light-dark cycle.4-6 The peak melatonin secretion occurs during the night hours; during the day, its concentrations are low. Exposure to light acutely suppresses nocturnal melatonin release. OBJECTIVES The aim of the study was to evaluate the profile of circadian melatonin secretion in patients with obstructive sleep apnea (OSA) and to assess the impact of 2-day and 3-month treatment with continuous airway pressure (CPAP) on diurnal and nocturnal serum melatonin levels.PATIENTS AND METHODS Serum melatonin levels were evaluated in 71 untreated patients with OSA and 18 healthy controls at 6 time points: 10 AM, 2 PM, 6 PM, 10 PM, 2 AM, and 6 AM. The measurements were repeated after 2 days and 3 months of CPAP treatment. RESULTSMelatonin secretion rhythm was altered in 25.4% of the patients with OSA. In patients with preserved secretion rhythm, the serum melatonin level was significantly lower at 2 AM and 6 AM, compared with healthy controls: 68.2 pg/ml (interquartile range [IQR], 30.1-109.8 pg/ml) vs 109.1 pg/ml (IQR, 63-167.9 pg/ml), P = 0.02 and 40.8 pg/ml (IQR,.2 pg/ml) vs 67.7 pg/ml (IQR, 32.7-131.7 pg/ml), P = 0.04, respectively. Melatonin levels did not change significantly after the 2-day and 3-month CPAP treatment. However, at 3 months, a shift of the peak melatonin concentration to 2 AM was observed in patients with an altered secretion rhythm.CONCLUSIONS OSA has a significant effect on serum melatonin levels. Neither short-term nor long-term CPAP treatment significantly changes melatonin concentrations; however, our results seem to indicate that a 3-month CPAP treatment may be helpful in restoring the physiological rhythm of melatonin secretion in patients with OSA.

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“…Melatoninin sirkadiyen değişiklik gösteren cGMP düzeyini artırdığı ve suprakiazmatik çekirdek düzeyinde sirkadiyen döngüyü engelleyerek uykuyu kolaylaştırdığı düşünülmek-tedir. 64,65 Melatonin, hipnotiklerin tersine, uykulu olma halinde ve kognitif performansta hızlı düzelme yapmamaktadır. 66 Uzun süreli kullanımı hakkında yeterli çalışma olmamasına karşın KOAH'lı hastaların uyku problemlerinin tedavisinde yararlı olacağı düşünülmektedir.…”

Section: Copd and Sleepunclassified

Chronic Obstructive Pulmonary Disease and Sleep

Öztürk¹

2011

Solunum

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ÖZETUykunun hava yolu direnci, solunum kaslarının kasılımı ve solunum kontrolü dahil olmak üzere solunum sistemi üzerine etkileri bulunmaktadır. Kişinin solunum sorunları yoksa bu deği-şiklikler fizyolojik sınırlar içinde kalmaktadır. Ancak solunum sorunu olan olgularda ve özellikle kronik obstrüktif akciğer hastalarında (KOAH) uyku ciddi sorun yaratmaktadır. KOAH'ta solunumun kontrolü, uyku ve uyanıklıkta sağlıklı bireylerle aynı temel özelliklere sahip olmasına karşın, solunum ve gaz değişi-mi olumsuz etkilenmekte ve hızlı göz hareketleri (REM) sırasın-da solunum kaslarında görülen atoni hiperkapni ve hipoksiyi derinleştirmektedir. Hipoksi arousalları (uyanayazma), uyku bölünmelerini, pulmoner hipertansiyonu ve mortalite riskini artırmaktadır. KOAH'lı olgularda diğer kronik hastalıklarda olduğu gibi hipoksi olmaksızın uyku kalitesi bozulmakta ve tedavide kullanılan ilaçlar da uyku bölünmelerine ve uykusuzluğa neden olabilmektedir. Bu derlemede KOAH ile uyku bozukluklarının birlikteliğini, fizyolojik mekanizmaları ve kliniğe yansımalarını incelemek istedik.Anahtar sözcükler: hipoventilasyon, Kronik Obstrüktif Akciğer Hastalığı (KOAH), pozitif hava yolu basıncı, uyku bozuklukları ABSTRACTSleep affects the respirotory system by causing changes in airway resistance, respiratory muscle contractility, and central respiratory control. In an individual who has no respiratory problems, these changes remain within physiological limits. However, in patients with respiratory problems, especially chronic obstructive pulmonary disease (COPD), sleep creates a serious problem.Although the control of breathing in patients with COPD follows the same basic principles as it does in normal subjects, both awake and asleep, the respiratory and gas exchange is adversely affected and the atonia of respiratory muscles during rapid eye movement (REM) sleep deepens the hypoxia and hypercapnia. The hypoxia leads to increased arousals, sleep disruptions, pulmonary hypertension, and higher mortality. As with other chronic diseases, the quality of sleep among patients with COPD deteriorates without hypoxia and the drugs used in therapy cause sleep deprivations and insomnia. This review presents an examination of the association of COPD and sleep disorders, including the physiologic mechanisms and their clinical implications. Tablo I). [3][4][5] Bu makalede KOAH hastalarında görülen uyku bozukluklarının mekanizmaları ve tedavi yöntemleri, güncel literatür yardımıyla tartışılmaktadır. Keywords Solunum Dergisi t Önder Öztürk 67 GİRİŞ

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Melatonin, sleep, and circadian rhythms

Cited by 132 publications

References 41 publications

Effect of melatonin administration on subjective sleep quality in chronic obstructive pulmonary disease

Effect of melatonin administration on subjective sleep quality in chronic obstructive pulmonary disease

Treatment with continuous positive airway pressure and diurnal and nocturnal serum melatonin concentration in patients with obstructive sleep apnea

Chronic Obstructive Pulmonary Disease and Sleep

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