Manacor Hospital, Occupational Health Service, 07500 Manacor, Spain.
Son Llàtzer Hospital, Occupational Health Service, 07198 Palma, Spain.
Int J Environ Res Public Health. 2022 Aug 17;19(16):10199. doi: 10.3390/ijerph191610199.
(1) Background: To know the medical documentation related to exogenous melatonin in sleep disorders caused by shift work in health personnel; (2) Methods: Systematic and critical review. Data were obtained by looking up the bibliographic data base: MEDLINE (via Pubmed), Embase, Cochrane Library, Scopus, Web of Science, Latin American and Caribbean literature in Health Sciences (LILACS) and Medicine in Spanish (MEDES). The used terms, as descriptors and text in the title and abstract record fields, were "Health Personnel", "Melatonin" and "Sleep Disorders", Circadian Rhythm, by using the following filters: "Humans", "Adult: 19+ years" and "Clinical Trial". The search update was in December 2021. The documentary quality of the articles was assessed using the CONSORT questionnaire. (3) Results: Having applied the inclusion and exclusion criteria, 10 clinical essays were selected out of 98 retrieved references. CONSORT scores ranged from a minimum of 6.0 to a maximum of 13. 7 with a median of 10.2. According to the SIGN criteria, this review presented "1-"evidence with a grade of recommendation B. The intervention dose via administration of exogenous melatonin ranged between 1 and 10 mg. It was not mentioned whether the route of administration was by fast or slow absorption. The outcomes showed decreased daytime sleepiness, lessened sleep onset latency, diminished night-time awakenings, increased total sleep period and improved daytime attention in the melatonin-treated group; (4) Conclusions: Exogenously administered melatonin is effective in shift worker health personnel that are suffering from sleep disorders, and given its low adverse effects and tolerability, it might be recommended. A great disparity was evidenced in terms of dose, follow-up periods and type of melatonin, small participant population, same age ranges and young age. Therefore, new trials would be needed to amend these observations in order to have full evidence that is able to ensure the efficacy of exogenous melatonin in the studied population.
(1) 背景：了解与轮班工作导致的健康人员睡眠障碍相关的外源性褪黑素的医学文献；(2) 方法：系统和批判性评价。通过查阅文献数据库获取数据：MEDLINE（通过 Pubmed）、Embase、Cochrane 图书馆、Scopus、Web of Science、拉丁美洲和加勒比健康科学文献（LILACS）和西班牙语医学文献（MEDES）。使用的术语作为描述符和标题及摘要记录字段中的文本是“卫生人员”、“褪黑素”和“睡眠障碍”、昼夜节律，使用以下筛选器：“人类”、“成人：19 岁及以上”和“临床试验”。文献更新于 2021 年 12 月。使用 CONSORT 问卷评估文章的文献质量。(3) 结果：在应用纳入和排除标准后，从检索到的 98 篇参考文献中选择了 10 篇临床论文。CONSORT 评分范围从最低 6.0 到最高 13.7，中位数为 10.2。根据 SIGN 标准，本综述提供了“1-”证据，推荐等级为 B。通过给予外源性褪黑素的干预剂量在 1 至 10 毫克之间。未提及给药途径是快速还是缓慢吸收。结果显示，褪黑素治疗组白天嗜睡减少，入睡潜伏期缩短，夜间觉醒减少，总睡眠时间增加，白天注意力提高；(4) 结论：外源性褪黑素对患有睡眠障碍的轮班工作健康人员有效，且由于其不良反应和耐受性低，可能会被推荐使用。在剂量、随访期和褪黑素类型、小的参与者人群、相同的年龄范围和年轻年龄方面存在很大差异。因此，需要开展新的试验来修正这些观察结果，以便获得充分的证据，确保研究人群中外源性褪黑素的疗效。
