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• W2913239370 abstract "The MIDNIGHT (Melatonin in doctors and nurses working nightshifts) trial was a randomised, placebo-controlled, double-blinded, cross-over pilot study to investigate the feasibility and acceptability of administration of exogenous melatonin (as Circadin) in medical and nursing staff working night shifts. Volunteers were randomised to receive 6 mg Circadin or placebo just before sleeping, after each of three consecutive night shifts. At the next set of shifts, at 4–6 weeks later, subjects received melatonin if they previously had placebo and vice versa. The target recruitment of 25 participants completing both arms of the study was achieved. Twelve participants (nine female/three male) received placebo followed by melatonin and 13 (eight female/five male) received melatonin first. All participants reported taking their trial medication and this concurred with drug accountability. Melatonin was not found in serum during the placebo phase. During the melatonin phase, median levels were 117 (10–1225), 83 (10–1430), and 309 (10–1050) pg ml–1, the morning after each of the three shifts, respectively; levels were highest after the third shift (P<0.01), suggesting some accumulation. Subjects had an increased propensity for situational sleepiness [Eppworth Sleepiness Score (ESS)] during and after each shift during both the placebo and the melatonin phases (both P<0.0001). However, during the melatonin phase ESS was lower during the last shift than the first two shifts (P=0.035); this was not seen during the placebo phase. Reaction times measured using psychomotor vigilance testing (PVT) were longer after each of the first two night shifts (P<0.05) but not after the third shift, and were not affected by melatonin. Correct double digit addition testing was similar before and after shifts during both the placebo and melatonin phases. Total sleep duration was increased and wake time after sleep onset was decreased during melatonin treatment (both P=0.04). Latency and efficiency were not affected. Participants gave positive feedback on the acceptability of trial design and organisation. We report here that the trial design for MIDNIGHT was both feasible and acceptable and that melatonin treatment in healthy night shift workers was well tolerated. During the first two night shifts staff reported sleepiness and had slower reaction times but showed signs of adaptation by shift 3. The study was not powered to show effects of melatonin, but there was some evidence that mid shift sleepiness was decreased and subjects slept longer when they took melatonin. These data will inform a sample size calculation for a definitive trial. BJA/RCoA Project Grant." @default.
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• W2913239370 date "2019-03-01" @default.
• W2913239370 modified "2023-09-27" @default.
• W2913239370 title "Melatonin in doctors and nurses working nightshifts—the MIDNIGHT trial" @default.
• W2913239370 doi "https://doi.org/10.1016/j.bja.2018.10.046" @default.
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