Abstract
Purpose
Studies suggest that melatonin may prevent delirium, a condition of acute brain dysfunction
occurring in 20%-30% of hospitalized older adults that is associated with increased
morbidity and mortality. We examined the effect of melatonin on delirium prevention
in hospitalized older adults while measuring sleep parameters as a possible underlying
mechanism.
Methods
This was a randomized clinical trial measuring the impact of 3 mg of melatonin nightly
on incident delirium and both objective and subjective sleep in inpatients age ≥65
years, admitted to internal medicine wards (non-intensive care units). Delirium incidence
was measured by bedside nurses using the confusion assessment method. Objective sleep
measurements (nighttime sleep duration, total sleep time per 24 hours, and sleep fragmentation
as determined by average sleep bout length) were obtained via actigraphy. Subjective
sleep quality was measured using the Richards Campbell Sleep Questionnaire.
Results
Delirium occurred in 22.2% (8/36) of subjects who received melatonin vs in 9.1% (3/33)
who received placebo (P = .19). Melatonin did not significantly change objective or subjective sleep measurements.
Nighttime sleep duration and total sleep time did not differ between subjects who
became delirious vs those who did not, but delirious subjects had more sleep fragmentation
(sleep bout length 7.0 ± 3.0 vs 9.5 ± 5.3 min; P = .03).
Conclusions
Melatonin given as a nightly dose of 3 mg did not prevent delirium in non-intensive
care unit hospitalized patients or improve subjective or objective sleep.
Keywords
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Article info
Publication history
Published online: May 02, 2018
Accepted:
April 19,
2018
Received in revised form:
April 7,
2018
Received:
February 19,
2018
Footnotes
☆Funding: This research was funded in part by a National Institutes of Health/National Center for Advancing Translational Sciences flagship Clinical and Translational Science Award Grant (KL2 TR001112 and UL1 TR001114), and a Scripps Clinic Medical Group Research and Education Grant.
✯✯Conflicts of Interest: None. Although ML is employed by Philips Respironics, the study design and interpretation of all data were done by the investigators.
✯Authorship: All of the authors contributed to this article by participation in the research and preparation of the manuscript. Additionally, all authors had access to the data and a role in writing the manuscript.
✯Trial Registration: Registered at CLINICALTRIALS.GOV: NCT02597231.
✯Data Statement: The de-identified data for this study are available upon reasonable request to the authors via e-mail to [email protected]
Identification
Copyright
© 2018 Elsevier Inc. All rights reserved.
