Melatonin and Quality of Life in Dialysis Patients
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Purpose
Sleep problems can lead to a bad quality of life and a raise of morbidity, also in dialysis patients. Sleep problems can be caused by a disturbance of circadian rhythms in our body. For a good regulation of these circadian rhythms a uniform external synchronisation is necessary. This is the synchronisation of the biological clock of our body by light and other influences. In case of a disturbance of the external synchronisation, due to for example naps during the day or wake periods at night, internal rhythms can be unlinked. As a result a weakened melatonin rhythm and a problematic sleep-wake cycle can be observed. Most dialysis patients have sleep problems. Their sleep latency is prolonged. They often take a nap during the day and their sleep efficiency is poor. There has only been one study on the melatonin rhythm of dialysis patients. The conclusion of this study was that the melatonin rhythm of dialysis patients is weakened and disturbed, probably caused by renal insufficiency. In this study no link was made between melatonin rhythm and the nature and severity of possible sleep problems. In different studies with non-dialysis patients and a disturbed melatonin rhythm, exogenous melatonin at the right time leads to a recovery of the normal rhythm and the normal biological clock and a better quality of life.
The aim is to improve quality of life of hemodialysis patients with a placebo-controlled study with melatonin to investigate if exogenous melatonin can improve sleep problems and on the longer term improve quality of life (and secondary morbidity) of dialysis patients.
| Condition | Intervention | Phase |
|---|---|---|
|
Sleep Problems Haemodialysis |
Drug: Melatonin tablet 3 mg once daily Drug: Placebo comparator |
Phase 3 |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Efficacy Study Intervention Model: Parallel Assignment Masking: Double Blind (Subject, Investigator) Primary Purpose: Treatment |
| Official Title: | Double Blind Placebo-controlled Study on the Efficacy of Melatonin on Sleep, Resulting in an Improved Quality of Life in Hemodialysis Patients |
- Improvement of vitality (dimension quality of life) by 15 points (RAND SF 36) [ Time Frame: 6-12 months ] [ Designated as safety issue: No ]
- Improvement general health by 15 points (dimension quality of life, RAND SF 36) [ Time Frame: 6-12 months ] [ Designated as safety issue: No ]
- Change in biochemical parameters [ Time Frame: 3-6-9-12 months ] [ Designated as safety issue: No ]
- Change in ProBNP [ Time Frame: 12 months ] [ Designated as safety issue: No ]
- Change in nutritional status [ Time Frame: 12 months ] [ Designated as safety issue: No ]
- Change in use of medication [ Time Frame: 6-12 months ] [ Designated as safety issue: No ]
- Change in preload [ Time Frame: 12 months ] [ Designated as safety issue: No ]
| Enrollment: | 68 |
| Study Start Date: | April 2007 |
| Study Completion Date: | December 2009 |
| Primary Completion Date: | October 2009 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Active Comparator: Melatonin
melatonin 3mg
|
Drug: Melatonin tablet 3 mg once daily
Melatonin tablet 3 mg once daily
|
| Placebo Comparator: Placebo |
Drug: Placebo comparator
Placebo comparator
|
Detailed Description:
Objective of the study:
Does melatonin by improving sleep parameters improve quality of life of hemodialysis patients?
Study design:
Placebo-controlled, double-blind, randomized trial
Study population:
hemodialysis patients
Intervention:
melatonin 3 mg once daily (or placebo)
Primary study parameters/outcome of the study:
- improvement of vitality (dimension quality of life) by 15 points (RAND SF 36)
- improvement general health by 15 points (dimension quality of life, RAND SF 36)
Secondary study parameters/outcome of the study:
- Change in biochemical parameters
- Change in ProBNP
- Change in nutritional status
- Change in use of medication
- Change in preload
Eligibility| Ages Eligible for Study: | 18 Years to 85 Years |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Informed Consent
- Man/Women between 18 and 85 years
- Understanding and knowledge of the dutch language
- End Stage Renal Disease, stable chronic hemodialysis > 3 months
- SpKt/V(total) > 1,2 pro dialysis
- Validated actometer shows that sleep efficiency < 90% or sleep latency > 15 minutes or fragmentation index > 25 points
Exclusion Criteria:
- Known major illness, which interferes with patient's participation in the study according to the investigator)or which results in a probable patient's survival of less than 1 year.
- Instable angina pectoris, heart failure NYHA class IV
- Pregnancy
- Current use of melatonin of known allergy of melatonin
- Participation in other medication/drug research within a month before inclusion
Contacts and Locations| Netherlands | |
| Meander Medical Center | |
| Amersfoort, Netherlands, 3800 BM | |
| Kennemer Gasthuis | |
| Haarlem, Netherlands, 2035 RC | |
| Study Chair: | Pieter ter Wee, MD, PhD | VU University Medical Center |
More Information
No publications provided
| Responsible Party: | Department of Clinical Pharmacy, Meander Medical Center |
| ClinicalTrials.gov Identifier: | NCT00388661 History of Changes |
| Other Study ID Numbers: | R-06.31 M / Melody, R-06.31 M |
| Study First Received: | October 16, 2006 |
| Last Updated: | July 19, 2011 |
| Health Authority: | Netherlands: Medical Ethics Review Committee (METC) |
Keywords provided by Meander Medical Center:
|
sleep problems quality of life melatonin sleep apnea |
medication preload nutritional status ProBNP |
Additional relevant MeSH terms:
|
Dyssomnias Sleep Disorders Parasomnias Nervous System Diseases Mental Disorders Neurologic Manifestations Signs and Symptoms Melatonin |
Central Nervous System Depressants Physiological Effects of Drugs Pharmacologic Actions Central Nervous System Agents Therapeutic Uses Antioxidants Molecular Mechanisms of Pharmacological Action Protective Agents |
ClinicalTrials.gov processed this record on June 18, 2013