Does exogenous melatonin improve day sleep or night alertness in emergency physicians working night shifts?
OBJECTIVE
To determine whether exogenous melatonin improves day sleep or night alertness in emergency physicians working night shifts.


METHODS
In a double-blind, placebo-controlled crossover trial, emergency physicians were given 10 mg sublingual melatonin or placebo each morning during one string of nights and the other substance during another string of nights of equal duration. During day-sleep periods, subjective sleep data were recorded. During night shifts, alertness was assessed with the use of the Stanford Sleepiness Scale. Key outcome comparisons were visual analog scale scores for gestalt night alertness and for gestalt day sleep for the entire string of nights.


RESULTS
We analyzed data from 18 subjects. Melatonin improved gestalt day sleep (P = .3) and gestalt night alertness (P = .03) but in neither case was the improvement statistically significant. Of 13 secondary comparisons, 9 showed a benefit of melatonin over placebo; none showed a benefit of placebo over melatonin.


CONCLUSIONS
Exogenous melatonin may be of modest benefit to emergency physicians working night shifts.
Jorgensen
K M
KM
Division of Emergency Medicine, University of Maryland Medical System, Baltimore, USA.
Witting
M D
MD
D000328:Adult; D001364:Awareness / Q000187:drug effects; D018592:Cross-Over Studies; D004311:Double-Blind Method; D004334:Drug Administration Schedule; D004635:Emergency Medicine; D005260:Female; D016166:Free Radical Scavengers / Q000008:administration & dosage / Q000494:pharmacology*; D006801:Humans; D008297:Male; D008550:Melatonin / Q000008:administration & dosage / Q000494:pharmacology*; D010147:Pain Measurement; D012890:Sleep / Q000187:drug effects*; D014940:Work Schedule Tolerance
D016166:Free Radical Scavengers; D008550:Melatonin