PDF(Pubmed)
Abstract：
UNASSIGNED: Evidence regarding the effectiveness of melatonin receptor agonists in treating delayed sleep-wake phase disorder (DSWPD) remains limited. This study aimed to determine the optimal dose of ramelteon, a melatonin receptor agonist, for the better treatment adherence of DSWPD.
UNASSIGNED: The patients who were diagnosed definitely as having DSWPD by board-certified physicians specialized in sleep medicine and started to receive strategically timed ramelteon medications after the diagnosis were included. Data on the initial ramelteon dose and follow-up duration (up to 24 months) were collected retrospectively. Patients with treatment discontinuation, changes in ramelteon dose, or the addition of other sleep-related medications were considered dropouts. Kaplan-Meier estimates, log-rank tests, and Cox regression analyses were performed.
UNASSIGNED: Overall, 373 patients were analyzed. The findings revealed that the 2 mg dose of ramelteon was associated with a lower dropout rate compared to the other doses (8 mg, 4 mg, and 1 mg). The dropout rate for the 2 mg group was estimated to have a hazard ratio (HR) of 0.5762 when compared with the 8 mg dose group. Sex did not reveal a significant HR, whereas older age exhibited a small but significant HR (0.9858).
UNASSIGNED: For achieving better adherence, a dosing regimen of strategically timed 2 mg ramelteon may be the best for the treatment of DSWPD. The therapeutic dose window for better adherence seems to center approximately 2 mg of ramelteon. Furthermore, caution should be exercised when treating younger patients to prevent dropouts.
UNASSIGNED: The patients who were diagnosed definitely as having DSWPD by board-certified physicians specialized in sleep medicine and started to receive strategically timed ramelteon medications after the diagnosis were included. Data on the initial ramelteon dose and follow-up duration (up to 24 months) were collected retrospectively. Patients with treatment discontinuation, changes in ramelteon dose, or the addition of other sleep-related medications were considered dropouts. Kaplan-Meier estimates, log-rank tests, and Cox regression analyses were performed.
UNASSIGNED: Overall, 373 patients were analyzed. The findings revealed that the 2 mg dose of ramelteon was associated with a lower dropout rate compared to the other doses (8 mg, 4 mg, and 1 mg). The dropout rate for the 2 mg group was estimated to have a hazard ratio (HR) of 0.5762 when compared with the 8 mg dose group. Sex did not reveal a significant HR, whereas older age exhibited a small but significant HR (0.9858).
UNASSIGNED: For achieving better adherence, a dosing regimen of strategically timed 2 mg ramelteon may be the best for the treatment of DSWPD. The therapeutic dose window for better adherence seems to center approximately 2 mg of ramelteon. Furthermore, caution should be exercised when treating younger patients to prevent dropouts.
摘要：
■关于褪黑激素受体激动剂治疗迟发性睡眠-觉醒期障碍(DSWPD)的有效性的证据仍然有限。本研究旨在确定ramelteon的最佳剂量，褪黑激素受体激动剂，为DSWPD更好的治疗依从性。
■被专门研究睡眠医学的董事会认证医师明确诊断为患有DSWPD的患者，并在诊断后开始接受战略性定时的ramelteon药物治疗。回顾性收集了有关初始ramelteon剂量和随访时间（长达24个月）的数据。停止治疗的患者，拉美脱剂量的变化，或添加其他睡眠相关药物被认为是辍学。Kaplan-Meier估计,对数秩测试，并进行Cox回归分析。
■总的来说，对373例患者进行分析。研究结果表明，与其他剂量（8mg，4毫克，和1毫克）。当与8mg剂量组相比时,2mg组的脱落率估计具有0.5762的风险比(HR)。性别没有显示重要的人力资源，而年龄较大的表现出较小但显着的HR（0.9858）。
■为了获得更好的依从性，策略性定时给药2mgramelteon可能是治疗DSWPD的最佳方案.更好的依从性的治疗剂量窗口似乎以大约2mg的ramelteon为中心。此外，治疗年轻患者时应谨慎，以防止辍学。
■被专门研究睡眠医学的董事会认证医师明确诊断为患有DSWPD的患者，并在诊断后开始接受战略性定时的ramelteon药物治疗。回顾性收集了有关初始ramelteon剂量和随访时间（长达24个月）的数据。停止治疗的患者，拉美脱剂量的变化，或添加其他睡眠相关药物被认为是辍学。Kaplan-Meier估计,对数秩测试，并进行Cox回归分析。
■总的来说，对373例患者进行分析。研究结果表明，与其他剂量（8mg，4毫克，和1毫克）。当与8mg剂量组相比时,2mg组的脱落率估计具有0.5762的风险比(HR)。性别没有显示重要的人力资源，而年龄较大的表现出较小但显着的HR（0.9858）。
■为了获得更好的依从性，策略性定时给药2mgramelteon可能是治疗DSWPD的最佳方案.更好的依从性的治疗剂量窗口似乎以大约2mg的ramelteon为中心。此外，治疗年轻患者时应谨慎，以防止辍学。
