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首页> 外文期刊>Critical care : >Effect of oral melatonin and wearing earplugs and eye masks on nocturnal sleep in healthy subjects in a simulated intensive care unit environment: which might be a more promising strategy for ICU sleep deprivation?
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Effect of oral melatonin and wearing earplugs and eye masks on nocturnal sleep in healthy subjects in a simulated intensive care unit environment: which might be a more promising strategy for ICU sleep deprivation?

机译：在模拟的重症监护病房环境中，口服褪黑激素以及戴着耳塞和眼罩对健康受试者的夜间睡眠的影响：这可能是ICU睡眠剥夺的更有希望的策略吗？

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IntroductionSleep deprivation is common in critically ill patients in the intensive care unit (ICU). Noise and light in the ICU and the reduction in plasma melatonin play the essential roles. The aim of this study was to determine the effect of simulated ICU noise and light on nocturnal sleep quality, and compare the effectiveness of melatonin and earplugs and eye masks on sleep quality in these conditions in healthy subjects.MethodsThis study was conducted in two parts. In part one, 40 healthy subjects slept under baseline night and simulated ICU noise and light (NL) by a cross-over design. In part two, 40 subjects were randomly assigned to four groups: NL, NL plus placebo (NLP), NL plus use of earplugs and eye masks (NLEE) and NL plus melatonin (NLM). 1?mg of oral melatonin or placebo was administered at 21:00 on four consecutive days in NLM and NLP. Earplugs and eye masks were made available in NLEE. The objective sleep quality was measured by polysomnography. Serum was analyzed for melatonin levels. Subjects rated their perceived sleep quality and anxiety levels.ResultsSubjects had shorter total sleep time (TST) and rapid eye movement (REM) sleep, longer sleep onset latency, more light sleep and awakening, poorer subjective sleep quality, higher anxiety level and lower serum melatonin level in NL night (P <0.05). NLEE had less awakenings and shorter sleep onset latency (P <0.05). NLM had longer TST and REM and shorter sleep onset latency (P <0.05). Compared with NLEE, NLM had fewer awakenings (P?=?0.004). Both NLM and NLEE improved perceived sleep quality and anxiety level (P?=?0.000), and NLM showed better than NLEE in perceived sleep quality (P?=?0.01). Compared to baseline night, the serum melatonin levels were lower in NL night at every time point, and the average maximal serum melatonin concentration in NLM group was significantly greater than other groups (P <0.001).ConclusionsCompared with earplugs and eye masks, melatonin improves sleep quality and serum melatonin levels better in healthy subjects exposed to simulated ICU noise and light.Trial registrationChinese Clinical Trial Registry ChiCTR-IPR-14005458. Registered 10 November 2014.
机译：简介在重症监护病房（ICU）的重症患者中，睡眠剥夺很常见。重症监护病房中的噪声和光以及血浆褪黑激素的减少起着重要作用。这项研究的目的是确定模拟ICU噪声和光对夜间睡眠质量的影响，并比较褪黑素，耳塞和眼罩对健康受试者在这些条件下的睡眠质量的有效性。方法本研究分为两个部分。在第一部分中，有40名健康受试者在基线夜晚睡觉，并通过交叉设计模拟了ICU噪声和光照（NL）。在第二部分中，将40名受试者随机分为四组：NL，NL加安慰剂（NLP），NL加使用耳塞和眼罩（NLEE）和NL加褪黑素（NLM）。在NLM和NLP中，连续4天在21:00给予1？mg口服褪黑激素或安慰剂。 NLEE提供了耳塞和眼罩。客观睡眠质量通过多导睡眠图测量。分析血清中的褪黑激素水平。结果：受试者的总睡眠时间（TST）和快速眼动（REM）睡眠时间较短，睡眠开始潜伏期较长，轻度睡眠和苏醒时间较长，主观睡眠质量较差，焦虑水平较高和血清水平较低NL夜晚的褪黑激素水平（P <0.05）。 NLEE的觉醒较少，睡眠发作潜伏期较短（P <0.05）。 NLM的TST和REM较长，睡眠发作潜伏期较短（P <0.05）。与NLEE相比，NLM的唤醒次数更少（P？=？0.004）。 NLM和NLEE均改善了感知的睡眠质量和焦虑水平（P <= 0.000），并且NLM在感知的睡眠质量方面表现出比NLEE更好的（P <= 0.01）。与基线夜间相比，NL夜间的每个时间点的血清褪黑激素水平都较低，并且NLM组的平均最大褪黑激素浓度显着高于其他组（P <0.001）。结论与耳塞和眼罩相比，褪黑激素改善了健康的受试者在模拟ICU噪声和光照下的睡眠质量和血清褪黑激素水平更好。试验注册中国临床试验注册中心ChiCTR-IPR-14005458。 2014年11月10日注册。

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