Melatonin and delayed sleep phase syndrome: ambulatory polygraphic evaluation

Area of Science:

• Chronobiology
• Sleep Medicine
• Pharmacology

Background:

• Delayed Sleep Phase Syndrome (DSPS) is a circadian rhythm disorder characterized by a persistent shift in the sleep-wake cycle.
• Current treatments for DSPS often rely on subjective patient reports, necessitating objective efficacy evaluations.
• Melatonin, a hormone regulating sleep, is a potential therapeutic agent for circadian rhythm disorders.

Purpose of the Study:

• To objectively evaluate the efficacy of low-dose oral melatonin (5 mg/day) in advancing the sleep-wake rhythm in patients diagnosed with DSPS.
• To quantify the impact of melatonin treatment on sleep onset and awakening times using objective sleep monitoring.
• To assess whether melatonin treatment affects sleep architecture in DSPS patients.

Main Methods:

• Six patients with DSPS were enrolled and underwent ambulatory sleep monitoring for 72 hours before and 48 hours after a one-month melatonin intervention.
• Melatonin dosage (5 mg/day) was individualized based on each patient's estimated dim light melatonin onset (DLMO) delay.
• Objective sleep parameters, including sleep onset, wake times, and sleep architecture, were analyzed.

Main Results:

• Melatonin treatment resulted in a significant mean advance of 115 minutes in sleep onset time.
• Patients experienced a mean advance of 106 minutes in their final awakening hour.
• No significant alterations in key sleep architecture parameters were observed during the treatment period.

Conclusions:

• Oral melatonin administration (5 mg/day) is an effective treatment for advancing sleep-wake rhythms in patients with DSPS.
• Objective sleep monitoring confirms the efficacy of melatonin in managing DSPS, aligning with previous subjective findings.
• Melatonin can be a valuable tool for DSPS management, offering significant improvements in sleep timing without disrupting normal sleep patterns.