Endogenous melatonin predicts efficacy of exogenous melatonin in consolidation of fragmented wrist-activity rhythm of adult patients with developmental brain disorders: a double-blind, placebo-controlled, crossover study.

摘要: Abstract Objective: We studied whether the endogenous melatonin patterns in adult patients with developmental brain disorders have any role response to exogenous given as a sleep-promoting medicine. Methods: Participants included 15 adults (18–60 years, five females) of varying etiologies, motor handicaps, and long-term history sleep problems. According 24-h serum melatonin, were divided into two subgroups: lower higher secretors. The pretreatment disorder was characterized by structured interview, ambulatory polysomnography 7-day wrist actigraphy. Patients received 1, 3, or 6 mg fast-release tablets, each for 4 weeks increasing order, at constant time 30 min before desired onset. Similarly, placebos different codes during 3 × 4 weeks. actigraphy repeated end drug period. Outcome measures six parameters non-parametric circadian rhythm analysis. Drug effects 40 confounding/modulating factors evaluated applying two-level regression analyses co-variables. Results: Exogenous decreased fragmentation rest–activity rhythm, increased day/night ratio activity advanced onset rest on more pronounced than secretors melatonin. Other contributing blindness some features original (disrupted cyclicity architecture reported daytime somnolence). Conclusions: consolidated fragmented about half patients. Low levels night predicted improvement drug. Higher doses not effective lowest dose.