目的:研究补充褪黑素作为创伤性脑损伤(TBI)后睡眠障碍患者的治疗选择。
方法:在6个电子数据库中进行了系统搜索(Medline,AMED,CINAHL,Embase,Scopus,和SPORTDiscus)从最早的记录到2022年4月。
方法:如果研究符合以下标准,则有资格纳入:a)TBI后睡眠障碍的人类参与者,b)褪黑激素或褪黑激素药物用作干预治疗睡眠障碍,和c)报告的褪黑激素给药结果。所有TBI严重程度类型(轻度,中度,和严重)是合格的。初始搜索共检索到595篇文章,9项研究符合资格标准。
方法:两名评审员独立地从符合条件的研究中提取数据并评估方法学质量。提取的数据包括参与者和伤害特征,褪黑素的介入特性,和睡眠结果。方法质量通过Downs和Black检查表进行评估。
结果:共纳入251例TBI诱发睡眠障碍的参与者(平均年龄:14.0-42.5岁)。褪黑激素,Circadin(缓释褪黑激素),或给药Ramelteon(褪黑激素受体激动剂)。剂量和干预持续时间为2至10mg和3至12周,分别。9项研究中有8项报告了褪黑激素治疗后的积极结果。主观睡眠质量显著改善,客观的睡眠效率,和总睡眠时间被发现与褪黑激素。减少自我报告的疲劳,焦虑,褪黑素治疗也观察到抑郁症状。褪黑素给药后未报告严重不良事件。
结论:褪黑素在短期使用后具有良好的耐受性,并且有可能成为TBI后睡眠障碍患者的治疗药物。褪黑激素被证明对睡眠质量有益,睡眠持续时间,睡眠效率。改善心理健康的其他临床相关结果表明,对于患有同时发生的情绪障碍和受伤后睡眠障碍的个体,使用褪黑激素可能是一种有希望的治疗选择。
To investigate the utility of melatonin supplementation as a treatment option for individuals with sleep disturbance after traumatic brain injury (TBI).
A systematic search was conducted in 6 electronic databases (Medline, AMED, CINAHL, Embase, Scopus, and SPORTDiscus) from earliest records to April 2022.
Studies were eligible for inclusion if they met the following criteria: a) human participants with sleep disturbance after TBI, b) melatonin or melatonergic agent used as an intervention to treat sleep disturbance, and c) outcomes of melatonin administration reported. All TBI severity types (mild, moderate, and severe) were eligible. The initial search retrieved a total of 595 articles, with 9 studies meeting the eligibility criteria.
Two reviewers independently extracted data from eligible studies and assessed methodological quality. Extracted data consisted of participant and injury characteristics, melatonin interventional properties, and sleep outcome. Methodological quality was assessed via the Downs and Black checklist.
A total of 251 participants with TBI-induced sleep disturbance (mean age range: 14.0-42.5 years) were included. Melatonin, Circadin (prolonged-release melatonin), or Ramelteon (melatonin receptor agonist) were administered. Dosages and intervention duration ranged from 2 to 10 mg and 3 to 12 weeks, respectively. Eight out of 9 studies reported positive outcomes after melatonin treatment. Significant improvements in subjective sleep quality, objective sleep efficiency, and total sleep time were found with melatonin. Reductions in self-reported fatigue, anxiety, and depressive symptoms were also observed with melatonin treatment. No serious adverse events were reported after melatonin administration.
Melatonin has good tolerability after short-term use and the potential to be a therapeutic agent for those with sleep disturbance after TBI. Melatonin was shown to be beneficial to sleep quality, sleep duration, and sleep efficiency. Additional clinically relevant outcomes of improved mental health suggest that melatonin use may be a promising treatment option for individuals experiencing co-occurring disorders of mood and sleep disturbance post-injury.