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Title: Sleep disruption in tetraplegia: a randomised, double-blind, placebo-controlled crossover trial of 3 mg melatonin.
Austin Authors: Spong, J;Kennedy, G A;Tseng, J;Brown, Douglas J;Armstrong, S M;Berlowitz, David J 
Affiliation: Spinal Research Institute, Austin Health, Heidelberg, Victoria, Australia
Institute for Breathing and Sleep, Austin Hospital, Melbourne, Victoria, Australia
Department of Emergency Medicine, The Northern Hospital, Melbourne, Victoria, Australia
Psychology Department, College of Arts, Victoria University, Melbourne, Victoria, Australia
Epworth Sleep Centre, Melbourne, Victoria, Australia
The Bronowski Institute of Behavioural Neuroscience, Kyneton, Victoria, Australia
Spinal Research Institute, Austin Health, Heidelberg, Victoria, Australia
Department of Medicine, Austin Health and Northern Health, University of Melbourne, Melbourne, Victoria, Australia
Institute for Breathing and Sleep, Austin Hospital, Melbourne, Victoria, Australia
Issue Date: 3-Jun-2014
Publication information: Spinal Cord 2014; 52(8): 629-34
Abstract: Randomised, double-blind, placebo-controlled crossover trial of melatonin supplementation to people with complete tetraplegia.To investigate the effect that 3 mg melatonin supplementation has on objective and subjective sleep, quality of life and mood of people living with complete tetraplegia.Austin Hospital Sleep Laboratory and participants' homes, Melbourne, Victoria, Australia.Two week run-in followed by 3 week nightly administration of 3 mg melatonin or placebo, 2-week washout and further 3 week administration of the opposite treatment. Four testing sessions were conducted; the last nights of the run-in, treatment and washout periods. Testing sessions involved recording full polysomnography, completing a questionnaire battery and collecting urine and blood samples. The questionnaires assessed mood, sleep symptoms and health-related quality of life, and the urine and plasma samples assayed 6-sulphatoxymelatonin (aMT6s) and melatonin levels, respectively. A sleep diary was completed throughout the study.Eight participants (mean (s.d.): age 49.5 years (16), postinjury 16.9 years (7.1)) were recruited in which seven concluded the protocol. Endogenous-circulating melatonin was significantly higher (P < or = 0.01) following melatonin (urine: 152.94 μg h(-1) (74.51), plasma: 43,554.57 pM (33,527.11)) than placebo (urine: 0.86 μg h(-1) (0.40), plasma: 152.06 pM (190.55)). Subjective sleep improved significantly following melatonin specifically for duration of sleep per night and psychological wellbeing. Objective sleep showed a significant increase in light sleep with melatonin, with all other sleep parameters being unchanged.These results suggest that increasing melatonin in people with complete tetraplegia is beneficial, especially for subjective sleep. Investigation of the pharmacokinetics of melatonin metabolism in this population is warranted.This project is proudly supported by the Transport Accident Commission.
Gov't Doc #: 24891007
DOI: 10.1038/sc.2014.84
Type: Journal Article
Subjects: Adult
Affect.drug effects
Antioxidants.metabolism.therapeutic use
Cross-Over Studies
Double-Blind Method
Melatonin.analogs & derivatives.blood.therapeutic use.urine
Middle Aged
Quadriplegia.complications.drug therapy.psychology
Quality of Life
Sleep Disorders.blood.drug therapy.etiology.urine
Appears in Collections:Journal articles

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