Melatonin in Treatment of Sleep Disorders in Elderly Patients with Chronic Obstructive Pulmonary Disease
Voronezh State Medical University named after N. N. Burdenko, Voronezh, The Russian Federation
*Corresponding author: Evgeniy S. Ovsyannikov, PhD. Department of faculty therapy, Voronezh State Medical University named after N.N. Burdenko. Voronezh, Russia. E-mail: firstname.lastname@example.org.
Published: June 16, 2017. doi: 10.21103/Article7(2)_OA4
Background: Chronic obstructive pulmonary disease (COPD) may frequently be complicated by sleep disorders, which worse quality of life and lead to other adverse consequences. The objective of the study was to analyze clinical course of the disease and quality of life in elderly patients with both COPD and sleep disorders.
Methods and Results: The study included 50 patients with moderate and severe COPD in age from 60 to 75 years (mean age, 66.12 ± 0.76 years). Patients were divided into 2 groups randomly. For patients in Group 1, 3 mg of melatonin was prescribed orally 30–40 minutes before bedtime for 14 days on the background of standard COPD therapy. Patients of Group 2 received only standard COPD therapy. After 12 months of follow-up, the number of exacerbations and hospitalizations for COPD significantly decreased in Group 1: from 3.74±0.19 to 1.91±0.20 times a year (P=0.0000) and from 2.08±0.18 to 1.35±0.18 (P=0.0046). In Group 2, the dynamics of these parameters was not statistically significant. In addition, along with the improvement of sleep quality in COPD patients during treatment with melatonin, both state and trait anxiety scores and depression level improved. In Group 1, SF-36 scores (PF, RP, BP, and GH) have also significantly improved.
Conclusion: Correction of sleep disorders by melatonin in elderly patients with COPD improved the effectiveness of COPD treatment, and reduced the frequency and duration of exacerbations and the number of outpatient visits and hospitalizations.
- Lozano R1, Naghavi M, Foreman K, Lim S, Shibuya K, Aboyans V, et al. Global and regional mortality from 235 causes of death for 20 age groups in 1990 and 2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet 2012; 380(9859): 2095-128. doi: 10.1016/S0140-6736(12)61728-0.
- Global Initiative for Chronic Obstructive Lung Disease (GOLD, 2017 REPORT). Available from: http://goldcopd.org/
- Gibson GJ, Loddenkemper R, Lundbäck B, Sibille Y. Respiratory health and disease in Europe: the new European Lung White Book. Eur Respir J. 2013;42(3):559-63. doi: 10.1183/09031936.00105513.
- Provotorov VM, Budnevskiĭ AV, Semenkova GG, Shishkina ES. [Proinflammatory cytokines in combination of coronary heart disease and chronic obstructive pulmonary disease]. Klin Med (Mosk). 2015, 93(2):5-9. [Article in Russian].
- Budnevsky AV, Esaulenko IE, Ovsyannikov ES, Zhusina YG. [Anemias in chronic obstructive pulmonary disease]. Ter Arkh. 2016;88(3):96-9. [Article in Russian].
- Budnevsky AV, Provotorov VM, Ul'yanova MI. [Chronic obstructive pulmonary disease and anemia: clinical manifestations and therapeutic strategy]. Klin Med (Mosk). 2016;94(9):677-83. [Article in Russian].
- Milewska A, Rysiak E, Zareba I, Holownia A, Mroz RM. Costs of Treatment of Chronic Obstructive Pulmonary Disease. Adv Exp Med Biol. 2016; 885:67-75. doi: 10.1007/5584_2015_199.
- Blanchette CM, Gross NJ, Altman P. Rising Costs of COPD and the Potential for Maintenance Therapy to Slow the Trend. Am Health Drug Benefits. 2014;7(2):98–106.
- Downs CA, Appel SJ. Chronic obstructive pulmonary disease: diagnosis and management. J Am Acad Nurse Pract. 2007;19(3):126-32.
- Kozhevnikova SA, Budnevsky AV. [Features of the clinical course of chronic obstructive pulmonary disease and quality of life in patients with coexisting metabolic syndrome]. Kazan Med Zh. 2016, 97(5):681-686. doi: 10.17750/kmj2016-681. [Article in Russian].
- Budnevsky AV, Isaeva YV, Malysh EY, Kozhevnikova SA. [Pulmonary rehabilitation as an effective method for optimizing therapeutic and preventive measures in patients with chronic obstructive pulmonary disease concurrent with metabolic syndrome]. Ter Arkh. 2016;88(8):25-9. [Article in Russian].
- Martinez FJ, Han MK, Flaherty K, Curtis J. Role of infection and antimicrobial therapy in acute exacerbations of chronic obstructive pulmonary disease. Expert Rev Anti Infect Ther. 2006;4(1):101-24.
- Vgontzas AN. The diagnosis and treatment of chronic insomnia in adults. Sleep. 2005;28(9):1047-8.
- Morin CM, Rodrigue S, Ivers H. Role of stress, arousal, and coping skills in primary insomnia. Psychosom Med. 2003;65(2):259-67.
- Rezaie L, Khazaie H, Yazdani F. Exploration of the experience of living with chronic insomnia: A qualitative study. Sleep Sci. 2016;9(3):179-185. doi: 10.1016/j.slsci.2016.07.001.
- Bellapart J, Boots R. Potential use of melatonin in sleep and delirium in the critically ill. Br J Anaesth. 2012;108(4):572-80. doi: 10.1093/bja/aes035.
- Zhdanova IV. Melatonin as a hypnotic: pro. Sleep Med Rev. 2005;9(1):51-65.
- Garzon C, Guerrero JM, Aramburu O, Gusman T. Effect of melatonin administration on sleep, behavioral disorders and hypnotic drug discontinuation in the elderly: a randomized, double-blind, placebo-controlled study. Aging Clin Exp Res. 2009;21(1):38-42.
- Reiter RJ, Tan DX, Mayo JC, Sainz RM, Leon J, Czarnocki Z. Melatonin as an antioxidant: biochemical mechanisms and pathophysiological implications in humans. Acta Biochim Pol. 2003;50(4):1129-46.
- Cajochen C, Krauchi K, Wirz-Justice A. Role of melatonin in the regulation of human circadian rhythms and sleep. J Neuroendocrinol. 2003;15(4):432-7.
- Budnevskiy AV, Tsvetikova LN, Ovsyannikov ES, Goncharenko OV. [A role of melatonin for occurrence of chronic obstructive pulmonary disease]. Russian Pulmonology. 2016; 26(3):372-378. doi: 10.18093/0869-0189-2016-26-3-372-378. [Article in Russian]
- Ware JE Jr, Sherbourne CD. The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Med Care. 1992;30(6):473-83.
- Ware JE Jr . SF-36 Health survey update. Spine (Phila Pa 1976). 2000;25(24):3130-9.
- Buscemi N, Vandermeer B, Hooton N, Pandya R, Tjosvold L, Hartling L, et al. Efficacy and safety of exogenous melatonin for secondary sleep disorders and sleep disorders accompanying sleep restriction: meta-analysis. BMJ. 2006; 332(7578):385–93
- . Brzezinski A, Vangel MG, Wurtman RJ, Norrie G, Zhdanova I, Ben-Shushan A, et al. Effects of exogenous melatonin on sleep: a meta-analysis. Sleep Med Rev. 2005;9(1):41-50.
- Dahlitz M, Alvarez B, Vignau J, English J, Arendt J, Parkes JD. Delayed sleep phase syndrome response to melatonin. Lancet. 1991;337(8750): 1121-4.
- Shamir E, Laudon M, Barak Y, Anis Y, Rotenberg V, Elizur A, et al. Melatonin improves sleep quality of patients with chronic schizophrenia. J Clin Psychiatry. 2000;61(5):373-7.
- Nunes DM, Mota RM, Machado MO, Pereira ED, Bruin VM, Bruin PF. Effect of melatonin administration on subjective sleep quality in chronic obstructive pulmonary disease. Braz J Med Biol Res. 2008;41(10):926-31.
The fully formatted PDF version is available.
International Journal of Biomedicine. 2017;7(2):108-110. © 2017 International Medical Research and Development Corporation. All rights reserved.