Abstract
Disruption of nocturnal sleep in an intensive care unit may remarkably affect production of melatonin, which is also known to have anti-inflammatory properties. In the present study, we aimed to investigate the effect of sleep quality on melatonin levels and inflammation after surgery. Thus, we compared the patients, who were screened in the side-rooms where the lights were dimmed and noise levels were reduced, with the patients who received usual care. Preoperative and postoperative urine 6-sulphatoxymelatonin, serum interleukin-1 (IL-1), interleukin-6 (IL-6), and c-reactive protein (CRP) levels were measured and data on sleep quality was collected using the Richards–Campbell Sleep Questionnaire. Postoperative CRP and IL-6 levels were greater in the control group than in the experimental group, whereas postoperative 24 h melatonin levels were greater than preoperative levels and the difference was steeper in the experimental group in concordance with sleep quality scores. Thus, the regulation of light and noise in ICUs may help the recovery after major surgeries in patients, potentially by increasing melatonin production, which has anti-inflammatory properties.
Highlights
Endogenous melatonin is produced by the pineal gland at night under normal conditions and regulates the sleep–wake cycle [1,2,3]
postoperative day (POD) 3 c-reactive protein (CRP) and POD 1 IL-6 levels were greater in the control group than in the experimental group (Table 2, Figures 1 and 2)
Even if the mean melatonin levels were greater in the experimental group, the difference did not reach statistical significance (Table 2, Figures 3 and 4)
Summary
Endogenous melatonin is produced by the pineal gland at night under normal conditions and regulates the sleep–wake cycle [1,2,3]. Sleep disturbances are accompanied by abnormal melatonin secretion, such as phase delay [3]. It is well known that artificial light administered at night suppresses melatonin production [3]. Medications, automatic blood pressure cuff inflation, patient care interventions, and other environmental factors such as noise may disrupt nocturnal sleep which may disturb the endogenous rhythms in intensive care unit patients and may affect melatonin production remarkably [3,4,5]. In addition to its physiological roles in regulating sleep patterns, melatonin has been demonstrated to provide anti-inflammatory effects [3]. Melatonin has been shown to counteract the rise in pro-inflammatory cytokine levels [6,7,8,9,10] and reduce elevated plasma CRP levels [11]
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