联合明亮光照和褪黑素疗法对睡眠和昼夜节律结果的疗效：系统评价。
The efficacy of combined bright light and melatonin therapies on sleep and circadian outcomes: A systematic review.
机构信息
Northern Clinical School, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia.
CIRUS, Centre for Sleep and Chronobiology, Woolcock Institute of Medical Research, NSW, Australia; Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, University of Sydney, NSW, Australia.
出版信息
Sleep Med Rev. 2021 Aug;58:101491. doi: 10.1016/j.smrv.2021.101491. Epub 2021 Apr 9.
The aim of this systematic review was to investigate the effects of combined melatonin and bright light therapies on improved sleep and circadian outcomes. We conducted a systematic review that resulted in a total of eight papers meeting criteria. Four papers investigated the effectiveness of combined therapy in inducing a circadian phase shift on healthy participants. Combined therapy outperformed single light and melatonin therapies in phase advancing, but not in delaying, dim light melatonin onset (DLMO). The other four papers investigated the effect of combined therapy on sleep outcomes. Two of them were performed in elderly populations suffering from cognitive decline and two in delayed sleep-wake phase disorder (DSWPD) patients. While combined therapy was more beneficial than single therapy in elderly populations it did not show any benefit in DSWPD patients. The reported adverse effects of melatonin in elderly populations must be carefully considered. Future studies should investigate the separate and combined effect of melatonin and bright light on sleep and circadian outcomes in different target populations.
本系统评价的目的是调查褪黑素与亮光联合疗法对改善睡眠和昼夜节律结果的影响。我们进行了一项系统评价，共纳入了 8 篇符合标准的论文。其中 4 篇论文研究了联合疗法在诱导健康参与者昼夜节律相位提前方面的有效性。联合疗法在促进相位提前方面优于单一光照和褪黑素疗法，但在延迟褪黑素分泌（DLMO）方面则不然。另外 4 篇论文研究了联合疗法对睡眠结果的影响。其中 2 篇在认知能力下降的老年人群中进行，2 篇在睡眠时相延迟障碍（DSWPD）患者中进行。虽然联合疗法在老年人群中的效果优于单一疗法，但在 DSWPD 患者中则没有显示出任何益处。必须仔细考虑褪黑素在老年人群中的不良反应。未来的研究应调查褪黑素和亮光分别和联合对不同目标人群的睡眠和昼夜节律结果的影响。
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