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Melatonin Increases Sleep Consolidation in Untreated OSA Patients
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A5893 - Melatonin Increases Sleep Consolidation in Untreated OSA Patients
Author Block: N. L. Deacon, E. Smales, D. Gilbertson, N. Bosompra, P. N. DeYoung, J. E. Orr, A. Malhotra; Medicine, UCSD sleep laboratory, San Diego, CA, United States.
Rationale: Intermittent hypoxia and sleep fragmentation/restriction in obstructive sleep apnea (OSA) lead to neurocognitive deficits, cardiovascular disease (CVD) and increased mortality. Melatonin (MLT) is not only a hypnotic, but also a potent antioxidant and anti-inflammatory. MLT improves sleep and neurocognitive function in other sleep disorders and improves many cardiometabolic outcomes in human disease, supporting the possibility that MLT may have therapeutic potential in OSA. Thus this study sought to determine the effects of 7 days 10mg melatonin treatment on OSA, sleep and systemic oxidative stress.
Methods: 20 otherwise healthy untreated OSA patients participated in this two week trial. Actigraphy compared sleep and activity for 6 days prior to in-laboratory polysomnography on the 7th (baseline) and 14th (MLT treatment) nights. 10mg MLT was taken on nights 8-14. To determine antioxidant and anti-inflammatory effects, blood was drawn at 10pm and 6am on nights 7 and 14. Serum samples will be sent to GENOX laboratories for analysis of total antioxidant status, C-Reactive protein and lipid peroxidation. Polysomnography was scored by a sleep technician according to AASM criteria. Student’s t-test was used to compare polysomnography and actigraphy data between conditions. Results presented as mean ± SD.
Results: 19 patients (female: 4, age: 53±2yrs; BMI: 28.6±0.9kg/m²; AHI: 39.2±18.7 /hr) have completed the study and the last participant is actively enrolled. During polysomnography mean SaO2 was higher when taking MLT (B= 92.6±1.8 % vs MLT= 93.0±1.4 %, p=0.049), with no other differences between conditions. Actigraphy during the 6 days prior to in-laboratory polysomnography showed no change in total sleep time during MLT treatment (B= 2208.9±89.8 min vs MLT= 2288.8±121.5 min, p=0.269). However, number of sleep intervals decreased (B= 7.18±0.48 vs MLT= 6.65±0.38, p=0.046) and interval sleep time increased (B= 234.5±11.8 min vs MLT= 304.8±21.4 min, p=0.001).
Conclusions: Although a small effect, higher mean SaO2 while taking MLT could improve cardiometabolic outcomes. Serum samples will be analysed to determine if MLT reduces oxidative stress and inflammation. However, despite no change in total sleep time, a reduction in sleep intervals and increased sleep interval time reflects increased sleep consolidation during MLT treatment. Via improving sleep, MLT improves neurocognitive function in other sleep disorders such as insomnia and delayed sleep phase. Thus this finding supports further investigation to determine whether MLT improves neurocognitive function in untreated OSA patients.
Author Block: N. L. Deacon, E. Smales, D. Gilbertson, N. Bosompra, P. N. DeYoung, J. E. Orr, A. Malhotra; Medicine, UCSD sleep laboratory, San Diego, CA, United States.
Rationale: Intermittent hypoxia and sleep fragmentation/restriction in obstructive sleep apnea (OSA) lead to neurocognitive deficits, cardiovascular disease (CVD) and increased mortality. Melatonin (MLT) is not only a hypnotic, but also a potent antioxidant and anti-inflammatory. MLT improves sleep and neurocognitive function in other sleep disorders and improves many cardiometabolic outcomes in human disease, supporting the possibility that MLT may have therapeutic potential in OSA. Thus this study sought to determine the effects of 7 days 10mg melatonin treatment on OSA, sleep and systemic oxidative stress.
Methods: 20 otherwise healthy untreated OSA patients participated in this two week trial. Actigraphy compared sleep and activity for 6 days prior to in-laboratory polysomnography on the 7th (baseline) and 14th (MLT treatment) nights. 10mg MLT was taken on nights 8-14. To determine antioxidant and anti-inflammatory effects, blood was drawn at 10pm and 6am on nights 7 and 14. Serum samples will be sent to GENOX laboratories for analysis of total antioxidant status, C-Reactive protein and lipid peroxidation. Polysomnography was scored by a sleep technician according to AASM criteria. Student’s t-test was used to compare polysomnography and actigraphy data between conditions. Results presented as mean ± SD.
Results: 19 patients (female: 4, age: 53±2yrs; BMI: 28.6±0.9kg/m²; AHI: 39.2±18.7 /hr) have completed the study and the last participant is actively enrolled. During polysomnography mean SaO2 was higher when taking MLT (B= 92.6±1.8 % vs MLT= 93.0±1.4 %, p=0.049), with no other differences between conditions. Actigraphy during the 6 days prior to in-laboratory polysomnography showed no change in total sleep time during MLT treatment (B= 2208.9±89.8 min vs MLT= 2288.8±121.5 min, p=0.269). However, number of sleep intervals decreased (B= 7.18±0.48 vs MLT= 6.65±0.38, p=0.046) and interval sleep time increased (B= 234.5±11.8 min vs MLT= 304.8±21.4 min, p=0.001).
Conclusions: Although a small effect, higher mean SaO2 while taking MLT could improve cardiometabolic outcomes. Serum samples will be analysed to determine if MLT reduces oxidative stress and inflammation. However, despite no change in total sleep time, a reduction in sleep intervals and increased sleep interval time reflects increased sleep consolidation during MLT treatment. Via improving sleep, MLT improves neurocognitive function in other sleep disorders such as insomnia and delayed sleep phase. Thus this finding supports further investigation to determine whether MLT improves neurocognitive function in untreated OSA patients.
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