Wright S W, Lawrence L M, Wrenn K D, Haynes M L, Welch L W, Schlack H M
Department of Emergency Medicine, Vanderbilt University Medical Center, Nashville, TN 37232-4700, USA.
Ann Emerg Med. 1998 Sep;32(3 Pt 1):334-40. doi: 10.1016/s0196-0644(98)70010-1.
Melatonin has received considerable publicity for its sleep-promoting properties; however, there is little scientific evidence of its efficacy. The objective of this study is to determine whether there are measurable beneficial effects from exogenous melatonin in emergency physicians after intermittent night-shift duty.
This randomized, placebo-controlled, double-blind, crossover trial was conducted in the emergency department of an urban tertiary care hospital. Fifteen emergency physicians were given melatonin 5 mg or placebo for 3 consecutive nights after night-shift duty with crossover to the opposite agent after a subsequent block of night shifts. The primary outcome measure was the global assessment of recovery measured by a visual analog scale. Secondary outcome measures included sleep quality, duration, and tiredness. In addition, the Profile of Mood States questionnaire and neuropsychologic testing were performed.
There was no difference between melatonin and placebo in the global assessment of recovery (60.4+/-16.9 and 58.9+/-14.5, respectively; P=.29). There were no differences in sleep quality, duration or tiredness scores, sleep latency, hours of sleep obtained per night, and night or early awakening at any measurement point. Profile of Mood States and neuropsychologic test performances were similar.
We found no beneficial effect of melatonin on sleep quality, tiredness, or cognitive function in emergency physicians after night-shift duty. Our results suggest that exogenous melatonin is of limited value in recovery from night-shift work in emergency physicians.
褪黑素因其促进睡眠的特性而备受关注；然而，几乎没有科学证据证明其有效性。本研究的目的是确定外源性褪黑素对急诊医生在间歇性夜班工作后是否有可测量的有益效果。
这项随机、安慰剂对照、双盲、交叉试验在一家城市三级护理医院的急诊科进行。15名急诊医生在夜班工作后连续3晚服用5毫克褪黑素或安慰剂，在随后的一轮夜班后交叉服用另一种药物。主要结局指标是通过视觉模拟量表进行的总体恢复评估。次要结局指标包括睡眠质量、时长和疲劳感。此外，还进行了情绪状态量表问卷调查和神经心理学测试。
在总体恢复评估中，褪黑素与安慰剂之间没有差异（分别为60.4±16.9和58.9±14.5；P = 0.29）。在任何测量点，睡眠质量、时长或疲劳感评分、入睡潜伏期、每晚睡眠时间以及夜间或早醒情况均无差异。情绪状态量表和神经心理学测试表现相似。
我们发现褪黑素对夜班工作后的急诊医生的睡眠质量、疲劳感或认知功能没有有益影响。我们的结果表明，外源性褪黑素在急诊医生从夜班工作中恢复方面的价值有限。
