Nagtegaal J E, Smits M G, Swart A C, Kerkhof G A, van der Meer Y G
Department of Clinical Pharmacy, Hospital 'de Gelderse Vallei' Ede/Bennekom, The Netherlands.
Headache. 1998 Apr;38(4):303-7. doi: 10.1046/j.1526-4610.1998.3804303.x.
The occurrence of headache and its change after treatment with melatonin 5 mg were studied in 30 patients with delayed sleep phase syndrome. The medication was taken 5 hours before the endogenous nocturnal plasma melatonin concentration had reached 10 pg/mL. Three women (aged 14, 14, and 23 years) suffered from chronic tension-type headache. Their headache disappeared within 2 weeks after the start of treatment with melatonin. One 54-year-old man suffered from disabling migraine attacks without aura, twice a week. After starting melatonin treatment, only three migraine attacks were reported in 12 months. Ever since his 40s, a 60-year-old man complained of cluster headache episodes lasting about 2 months, twice a year. In the year since starting melatonin treatment, only one 5-day cluster episode occurred. Nocturnal melatonin secretion in the patients with delayed sleep phase syndrome and headache did not differ significantly from that in the patients with the sleep disorder but without headache. Melatonin may be helpful in patients with headache who are suffering from delayed sleep phase syndrome. Its effectiveness may be due to modification of vascular and nociceptive systems or to its chronobiological action which adjusts the patient's biological clock to his/her life-style.
对30例睡眠时相延迟综合征患者，研究了服用5毫克褪黑素后头痛的发生情况及其治疗后的变化。药物在内源性夜间血浆褪黑素浓度达到10皮克/毫升前5小时服用。3名女性（年龄分别为14岁、14岁和23岁）患有慢性紧张型头痛。她们的头痛在开始服用褪黑素治疗后2周内消失。一名54岁男性患有无先兆的致残性偏头痛发作，每周两次。开始褪黑素治疗后，12个月内仅报告了3次偏头痛发作。一名60岁男性从40多岁起就抱怨每年有两次丛集性头痛发作，持续约2个月。开始褪黑素治疗后的一年里，仅发生了一次为期5天的丛集性发作。睡眠时相延迟综合征伴头痛患者的夜间褪黑素分泌与患有睡眠障碍但无头痛的患者相比，无显著差异。褪黑素可能对患有睡眠时相延迟综合征的头痛患者有帮助。其有效性可能归因于对血管和伤害感受系统的调节，或归因于其调整患者生物钟以适应其生活方式的时间生物学作用。
