Costello Rebecca B, Lentino Cynthia V, Boyd Courtney C, O'Connell Meghan L, Crawford Cindy C, Sprengel Meredith L, Deuster Patricia A
Uniformed Services University of the Health Sciences, Department of Military and Emergency Medicine, 4301 Jones Bridge Road, Bethesda, MD 20814-4799, USA.
Nutr J. 2014 Nov 7;13:106. doi: 10.1186/1475-2891-13-106.
A systematic review was conducted using Samueli Institute's Rapid Evidence Assessment of the Literature (REAL) process to determine the evidence base for melatonin as an agent to optimize sleep or improve sleep quality, and generalize the results to a military, civilian, or other healthy, active, adult population. Multiple databases were searched yielding 35 randomized controlled trials (RCTs) meeting the review's inclusion criteria, which were assessed for methodological quality as well as for melatonin effectiveness. The majority of included studies were high quality (83.0%). Overall, according to Grading Recommendations, Assessment Development and Evaluation (GRADE) methodology, weak recommendations were made for preventing phase shifts from jet lag, for improving insomnia in both healthy volunteers and individuals with a history of insomnia, and for initiating sleep and/or improving sleep efficacy. Based on the literature to date, no recommendations for use in shift workers or to improve hormonal phase shift changes in healthy people can be made at this time. Larger and longer-duration RCTs utilizing well characterized products are needed to warrant melatonin recommendations in young, healthy adults.
采用萨缪利研究所的文献快速证据评估（REAL）流程进行了一项系统评价，以确定褪黑素作为一种优化睡眠或改善睡眠质量的药物的证据基础，并将结果推广至军人、平民或其他健康、活跃的成年人群体。检索了多个数据库，得到35项符合该评价纳入标准的随机对照试验（RCT），对这些试验进行了方法学质量以及褪黑素有效性的评估。纳入研究中的大多数质量较高（83.0%）。总体而言，根据推荐分级、评估、制定与评价（GRADE）方法，对于预防时差导致的相位偏移、改善健康志愿者和有失眠病史个体的失眠、启动睡眠和/或提高睡眠效率，给出了弱推荐。基于目前的文献，此时无法给出关于轮班工作者使用或改善健康人群激素相位变化的推荐。需要开展使用特征明确产品的规模更大、持续时间更长的RCT，才能为年轻健康成年人使用褪黑素提供推荐依据。
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