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首页> 外文期刊>The Canadian journal of hospital pharmacy. >Should Melatonin Be Used as a Sleeping Aid for Elderly People?
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Should Melatonin Be Used as a Sleeping Aid for Elderly People?

机译：褪黑激素应该用作老年人的睡眠援助吗？

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THE "PRO" SIDE Sales of exogenous melatonin, a hormone that regulates the arcadian rhythm, have increased significantly over the past few years. In the United States, the most recent National Health Interview Survey showed that the overall use of melatonin among adults more than doubled between 2007 and 2012, to an estimated 3.1 million users. Research has shown that endogenous melatonin levels decline with age, thereby providing the rationale to use melatonin supplements for sleep.1 However, before considering this treatment, it is critical to determine the situations in which it may be effective and safe. More importantly, pharmacists should be aware of the situations where it has not been proven effective and therefore should not be recommended. For chronic insomnia, melatonin has a statistically significant but relatively small effect on sleep latency, with a mean reduction of 9 min relative to placebo (95% confidence interval [CI] 2-15 min). The effect on total sleep time or sleep quality is generally considered small or nonsignificant.3 The practice guideline of the American Academy of Sleep Medicine (AASM) suggests ramelteon (a melatonin receptor agonist that is not available in Canada) as a treatment for sleep-onset insomnia, since its benefits marginally outweigh its harms, with limited to no consistent evidence of adverse events in excess of placebo (mean difference on sleep latency relative to placebo 10 min, 95% CI 6-13 min). The AASM guideline does not recommend melatonin for insomnia in adults, because the quality of the evidence is lower, but it does report mixed evidence suggesting a possible greater improvement in sleep latency in the subpopulation of older adults (mean difference in sleep latency relative to placebo 16 min, 95% CI 6—25 min).
机译：在过去几年中，调节Arcadian节奏的外源褪黑激素的“Pro”侧销售，这是一种调节Arcadian节奏的激素。在美国，最近的全国卫生面试调查显示，2007年至2012年成人之间的成年人之间的全面使用褪黑激素，估计为310万用户。研究表明，内源性褪黑激素水平随着年龄的增长而下降，从而提供了使用褪黑素补充剂的理由来睡眠。然而，在考虑这种处理之前，确定它可能有效和安全的情况至关重要。更重要的是，药剂师应该了解其尚未得到证实有效的情况，因此不应推荐。对于慢性失眠，褪黑激素对睡眠等待时间有统计学显着但相对较小的影响，相对于安慰剂平均减少9分钟（95％置信区间[Ci] 2-15分钟）。对总睡眠时间或睡眠质量的影响通常被认为是小或不可思议的.3美国睡眠医学院（AASM）的实践指南（AASM）表明Ramelteon（加拿大不可用的褪黑激素受体激动剂）作为睡眠的治疗方法 - 发病失眠，因为它的益处略胜于其危害，但没有限制不良事件的不良事件，其过剩的安慰剂（相对于安慰剂的睡眠潜伏期的平均差异10分钟，95％CI 6-13分钟）。 AASM指南不推荐成人内失眠的褪黑素，因为证据的质量较低，但它确实报告了混合证据表明在老年人的贫困中可能更大的睡眠潜伏期（睡眠潜伏期的平均差异相对于安慰剂16分钟，95％CI 6-25分钟）。

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