Efficacy and Safety of Prolonged-Release Melatonin for Primary Insomnia in Elderly Patients

Young-Min Park, So-Jin Lee, Jin-Seong Lee, Kyoung-Sae Na, Seung-Gul Kang, Bun-Hee Lee, Ho-Kyoung Yoon, Eui-Joong Kim
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Abstract

Objective: Insomnia, a prevalent sleep disorder affecting the elderly, necessitates effective and safe treatment options. This study explores the potential of the prolonged-release melatonin (Circadin®) addressing insomnia in elderly patients.Methods: The 8-week prospective observational study involved 115 participants, assessing sleep parameters using the Pittsburgh Sleep Quality Index (PSQI) and WHO-5 Well-being Index. The prolonged-release melatonin (2 mg) was administered nightly, and assessments were conducted at baseline, 4 weeks, and 8 weeks.Results: Both per protocol and last observation carried forward (LOCF) analyses consistently revealed significant improvements in sleep latency, total sleep time, sleep efficiency, and overall well-being. Notably, sleep latency decreased after 4 and 8 weeks, while total sleep time and sleep efficiency increased, reflecting longer and more restful sleep. The WHO-5 Well-being Index exhibited noticeable enhancement. Adverse events, including dizziness and heartburn, were manageable. Despite a high dropout rate, this drug’s potential as an efficacious and safe treatment option for elderly insomnia patients was evident, aligned with prior research.Conclusion: The prolonged-release formulation’s resemblance to the natural circadian rhythm of melatonin release offers advantages over conventional medications. This study contributes to understanding the prolonged-release melatonin’s promise as a valuable therapeutic alternative, encouraging further investigation into its longterm effects and optimal implementation.
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缓释褪黑素治疗老年原发性失眠症的疗效和安全性
目的:失眠是一种影响老年人的普遍睡眠障碍,需要有效和安全的治疗方案。本研究探讨了缓释褪黑激素(Circadin<sup>®</sup>)治疗老年患者失眠的潜力。方法:这项为期8周的前瞻性观察性研究涉及115名参与者,使用匹兹堡睡眠质量指数(PSQI)和WHO-5幸福指数评估睡眠参数。每晚给予缓释褪黑素(2mg),并在基线、4周和8周进行评估。结果:每个方案和最后一次观察结转(LOCF)分析一致显示睡眠潜伏期、总睡眠时间、睡眠效率和整体健康状况有显著改善。值得注意的是,4周和8周后,睡眠潜伏期减少,而总睡眠时间和睡眠效率增加,反映出睡眠时间更长、更安宁。世卫组织5幸福指数明显提高。包括头晕和胃灼热在内的不良事件是可控的。尽管辍学率很高,但与先前的研究一致,这种药物作为老年失眠症患者有效且安全的治疗选择的潜力是显而易见的。结论:该缓释制剂与褪黑激素释放的自然昼夜节律相似,比传统药物具有优势。这项研究有助于了解长效褪黑素作为一种有价值的治疗选择的前景,鼓励进一步研究其长期效果和最佳实施。
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