Melatonin helps critically ill patients sleep

Treatment with melatonin, a brain hormone that helps control the body's sleep and wake cycle, can help critically ill patients get a better night's sleep, according to a report in the journal Critical Care. Melatonin is also known to be a powerful antioxidant.

Dr. Richard S. Bourne from Northern General Hospital, Sheffield, UK and colleagues examined the effect of melatonin versus placebo on sleep in 24 critically ill patients who were attempting to come off of a ventilator.

At nighttime, melatonin-treated patients slept 3.5 hours, while those given placebo slept 2.5 hours. Although this difference was not considered significant from a statistical standpoint, other tests showed that the quality of sleep experienced by the melatonin group was much better.

"We would like to follow this investigation with a larger study in critical care patients using a lower dose of melatonin," Bourne commented. He noted that the dose used in the current study was probably too high because melatonin levels were still elevated in the morning.

Despite the promising results, there are many causes of sleep disturbances in critical care patients, he pointed out, so a single intervention, such as treatment with melatonin, is unlikely to have a dramatic effect.

"Multi-component interventions that include attempts to reduce environmental disturbances, ventilator (discomfort), and inappropriate medication, as well as attempts to reinforce a patient's circadian rhythm, are probably required," Bourne concluded.

SOURCE: Critical Care, April 18th online issue 2008.