Melatonin Secretion Pattern in Critically Ill Patients: A Pilot Descriptive Study
Critically ill patients have abnormal circadian and sleep homeostasis. This may be associated with higher morbidity and mortality. The aims of this pilot study were (1) to describe melatonin secretion in conscious critically ill mechanically ventilated patients and (2) to describe whether melatonin...
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| Format: | Article |
| Language: | English |
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Wiley
2017-01-01
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| Series: | Critical Care Research and Practice |
| Online Access: | http://dx.doi.org/10.1155/2017/7010854 |
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| author | Yuliya Boyko René Holst Poul Jennum Helle Oerding Miki Nikolic Palle Toft |
| author_facet | Yuliya Boyko René Holst Poul Jennum Helle Oerding Miki Nikolic Palle Toft |
| author_sort | Yuliya Boyko |
| collection | DOAJ |
| description | Critically ill patients have abnormal circadian and sleep homeostasis. This may be associated with higher morbidity and mortality. The aims of this pilot study were (1) to describe melatonin secretion in conscious critically ill mechanically ventilated patients and (2) to describe whether melatonin secretion and sleep patterns differed in these patients with and without remifentanil infusion. Eight patients were included. Blood-melatonin was taken every 4th hour, and polysomnography was carried out continually during a 48-hour period. American Academy of Sleep Medicine criteria were used for sleep scoring if sleep patterns were identified; otherwise, Watson’s classification was applied. As remifentanil was periodically administered during the study, its effect on melatonin and sleep was assessed. Melatonin secretion in these patients followed a phase-delayed diurnal curve. We did not observe any effect of remifentanil on melatonin secretion. We found that the risk of atypical sleep compared to normal sleep was significantly lower (p<0.001) under remifentanil infusion. Rapid Eye Movement (REM) sleep was only observed during the nonsedation period. We found preserved diurnal pattern of melatonin secretion in these patients. Remifentanil did not affect melatonin secretion but was associated with lower risk of atypical sleep pattern. REM sleep was only registered during the period of nonsedation. |
| format | Article |
| id | doaj-art-abeaf1e7a48a4c038a1a86c1e1e11475 |
| institution | Kabale University |
| issn | 2090-1305 2090-1313 |
| language | English |
| publishDate | 2017-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Critical Care Research and Practice |
| spelling | doaj-art-abeaf1e7a48a4c038a1a86c1e1e114752025-02-03T05:51:54ZengWileyCritical Care Research and Practice2090-13052090-13132017-01-01201710.1155/2017/70108547010854Melatonin Secretion Pattern in Critically Ill Patients: A Pilot Descriptive StudyYuliya Boyko0René Holst1Poul Jennum2Helle Oerding3Miki Nikolic4Palle Toft5Department of Anesthesia and Intensive Care Medicine, Odense University Hospital and Southern Danish University, Odense, DenmarkInstitute of Regional Health Service Research, University of Southern Denmark, Odense, DenmarkDanish Center for Sleep Medicine, Department of Clinical Neurophysiology, Rigshospitalet, and Faculty of Health, University of Copenhagen, Copenhagen, DenmarkDepartment of Anesthesia and Intensive Care Medicine, Vejle Hospital, Vejle, DenmarkDanish Center for Sleep Medicine, Department of Clinical Neurophysiology, Rigshospitalet, Copenhagen, DenmarkDepartment of Anesthesia and Intensive Care Medicine, Odense University Hospital and Southern Danish University, Odense, DenmarkCritically ill patients have abnormal circadian and sleep homeostasis. This may be associated with higher morbidity and mortality. The aims of this pilot study were (1) to describe melatonin secretion in conscious critically ill mechanically ventilated patients and (2) to describe whether melatonin secretion and sleep patterns differed in these patients with and without remifentanil infusion. Eight patients were included. Blood-melatonin was taken every 4th hour, and polysomnography was carried out continually during a 48-hour period. American Academy of Sleep Medicine criteria were used for sleep scoring if sleep patterns were identified; otherwise, Watson’s classification was applied. As remifentanil was periodically administered during the study, its effect on melatonin and sleep was assessed. Melatonin secretion in these patients followed a phase-delayed diurnal curve. We did not observe any effect of remifentanil on melatonin secretion. We found that the risk of atypical sleep compared to normal sleep was significantly lower (p<0.001) under remifentanil infusion. Rapid Eye Movement (REM) sleep was only observed during the nonsedation period. We found preserved diurnal pattern of melatonin secretion in these patients. Remifentanil did not affect melatonin secretion but was associated with lower risk of atypical sleep pattern. REM sleep was only registered during the period of nonsedation.http://dx.doi.org/10.1155/2017/7010854 |
| spellingShingle | Yuliya Boyko René Holst Poul Jennum Helle Oerding Miki Nikolic Palle Toft Melatonin Secretion Pattern in Critically Ill Patients: A Pilot Descriptive Study Critical Care Research and Practice |
| title | Melatonin Secretion Pattern in Critically Ill Patients: A Pilot Descriptive Study |
| title_full | Melatonin Secretion Pattern in Critically Ill Patients: A Pilot Descriptive Study |
| title_fullStr | Melatonin Secretion Pattern in Critically Ill Patients: A Pilot Descriptive Study |
| title_full_unstemmed | Melatonin Secretion Pattern in Critically Ill Patients: A Pilot Descriptive Study |
| title_short | Melatonin Secretion Pattern in Critically Ill Patients: A Pilot Descriptive Study |
| title_sort | melatonin secretion pattern in critically ill patients a pilot descriptive study |
| url | http://dx.doi.org/10.1155/2017/7010854 |
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