The role of melatonin and melatonin receptor agonist in the prevention of sleep disturbances and delirium in intensive care unit - a clinical review.
Study Goal
The researchers aimed to evaluate the role of melatonin and ramelteon in preventing sleep disturbances and delirium in ICU patients.
Results Summary
The study found that melatonin and ramelteon supplementation may reduce delirium incidence and severity by addressing sleep disturbances, potentially decreasing mechanical ventilation time and the need for psychoactive substances in ICUs. However, further studies with larger participant numbers are needed to confirm these effects.
Population
Intensive care unit (ICU) patients
Effective Dosage
Not specified
Duration
Not specified
Interactions
None mentioned
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
Melatonin and melatonin receptor agonist | neutral | sleep disturbances | - | - | is widely used agent in the therapy of | #1 |
Enteral melatonin and ramelteon supplementation | decrease | the delirium inducing factors | - | - | eliminates (partially) | #2 |
melatonin and ramelteon | neutral | delirium and sleep disorders | intensive care units | - | role in the prevention of | #3 |
therapy with these agents | decrease | the ventilation time of mechanical time | ICU environment | - | effect on reducing | #4 |
therapy with these agents | decrease | the demand for psychoactive substances | ICU environment | - | effect on reducing | #5 |
melatonin therapy | neutral | impact on these factors | ICU setting | - | efficacy requires confirmation in studies | #6 |
AIM: The intensive care unit (ICU) environment contributes to the development of sleep disturbances. Sleep disturbances, sleep fragmentation, and multiple awakening episodes lead to the circadian rhythm disorder, which increases the risk of delirium. Melatonin and melatonin receptor agonist is widely used agent in the therapy of sleep disturbances. However, there is also some for its efficacy in ICU delirium. Enteral melatonin and ramelteon supplementation eliminates (partially) the delirium inducing factors. METHODS: PubMed/MEDLINE, OVID, Embase, Cochrane Library, and Web of Science databases were searched using adequate key words. We reviewed the literature on the role of melatonin and ramelteon in the prevention of sleep disturbances and delirium in intensive care units and analysed the methods of melatonin therapy in an ICU setting. Review followed the PRISMA statement. A review written protocol was not drafted. RESULTS: Originally 380 studies were searched in five scientific databases. After rejecting the duplicate results, 125 results were obtained. Finally, 10 scientific studies were included in the review. In selected articles, the leading topics analysed were the role of melatonin and ramelteon in the prevention of delirium and sleep disorders. In addition, the noted effect of therapy with these agents on reducing the ventilation time of mechanical time and the demand for psychoactive substances in the ICU environment. CONCLUSION: Reduction of either the incidence or the severity of delirium course is possible by eliminating its risk factors. Risk factors are directly related to sleep disorders. To reduce the problem, therefore, a holistic approach to the source is necessary. The efficacy of melatonin therapy in an ICU setting requires confirmation in studies including a greater number of participants as the impact of melatonin on these factors is yet to be fully elucidated. However, the prognosis is predictive because this concept provides patients with a minimally invasive and natural form of therapy.