Afternoon serum-melatonin in sleep disordered breathing

Authors


MD Jan Ulfberg The Sleep Laboratory, Avesta Hospital, S-774 82 Avesta, Sweden.

Abstract

Ulfberg J, Micic S, Strøm J (Sleep Laboratory, Department of Internal Medicine, Avesta Hospital, Sweden, Department of Biotechnology, Statens Seruminstitut, Copenhagen, Denmark and the Department of Anaesthesiology, Glostrup University Hospital, Copenhagen, Denmark). Afternoon serum-melatonin in sleep disordered breathing. J Intern Med 1998; 244: 163–8.

Objectives

To study afternoon serum-melatonin values in patients with sleep disordered breathing. Melatonin has a strong circadian rhythm with high values during the night-time and low values in the afternoon. Sleep disordered breathing may change the circadian rhythm of melatonin which may have diagnostic implications.

Setting

The Sleep Laboratory, The Department of Internal Medicine, Avesta Hospital, Sweden, and the Department of Anaesthesiology, Glostrup University Hospital, Copenhagen, Denmark.

Subjects

We examined 60 consecutive patients admitted for sleep disordered breathing and 10 healthy non snoring controls. The patients underwent a sleep apnoea screening test having a specificity of 100% for the obstructive sleep apnoea syndrome (OSAS) using a combination of static charge sensitive bed and oximetry. Obstructive sleep apnoea syndrome was found in 49 patients, eight patients had borderline sleep disordered breathing (BSDB) and three patients were excluded due to interfering disease.

Main outcome measures

Patients and controls had an afternoon determination of serum-melatonin. The Epworth Sleepiness Scale was used to score daytime sleepiness.

Results

In comparison with normal controls patients suffering from OSAS had significantly higher serum-melatonin levels in the afternoon. However, as a diagnostic test for OSAS in patients with sleep disordered breathing serum-melatonin showed a low sensitivity but a high specificity. The results indicate that breathing disorders during sleep in general affect pineal function.

Conclusions

Sleep disordered breathing seems to disturb pineal function. Determination of afternoon serum-melatonin alone or together with a scoring of daytime sleepiness does not identify OSAS-patients in a heterogeneous population of patients complaining of heavy snoring and excessive daytime sleepiness.

Ancillary