Abstract
Background
Alcoholic patients show prominent disturbance of sleep as measured by electroencephalogram,
with difficulties in the onset and maintenance of sleep. Given the role of melatonin
in the regulation of the sleep–wake cycle, this study examined the relationship between
nocturnal expression of melatonin and sleep in alcoholics as compared with control
subjects.
Methods
Alcoholic patients (n = 11) and comparison control subjects (n = 10) underwent all-night polysomnography and serial blood sampling every 30 min
from 10:00 pm to 6:30 am for measurement of circulating levels of melatonin and cortisol.
Results
Coupled with prolonged sleep latency, alcoholics showed lower levels of melatonin
during the early part of the night and a delay in the onset of the nocturnal plateau
or peak value of melatonin as compared with control subjects. The nocturnal delay
of melatonin correlated with prolonged sleep latency. Circulating levels of cortisol
were lower during the early part of the night and higher in the late part of night
in the alcoholics as compared with the control subjects.
Conclusions
A delay in the nocturnal rise of melatonin may contribute to disordered sleep in chronic
alcoholics, with implications for the use of melatonin in the treatment of insomnia
in recovering alcoholics.
Keywords
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Biological PsychiatryAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Disturbances of hypothalamic-pituitary-adrenal axis functioning during ethanol withdrawal in six men.Am J Psychiatry. 1991; 148: 1023-1025
- Diagnostic and Statistical Manual of Mental Disorders. 4th ed. American Psychiatric Press, Washington, DC1994
- Serum melatonin in relation to clinical variables in patients with major depressive disorder and a hypothesis of a low melatonin syndrome.Acta Psychiatr Scand. 1985; 71: 319-330
- Polysomnographic and subjective sleep predictors of alcoholic relapse.Alcohol Clin Exp Res. 1998; 22: 1864-1871
- Melatonin in humans.NEJM. 1997; 336: 186-195
- A new, semi-structured psychiatric interview for use in genetic linkage studies.J Stud Alcohol. 1994; 55: 149-158
- A power primer.Psychol Bull. 1992; 112: 155-159
- Ageing and the circadian and homeostatic regulation of human sleep during forced desynchrony of rest, melatonin and temperature rhythms.J Physiol. 1999; 516: 611-627
- The sleep of abstinent pure primary alcoholic patients.Alcohol Clin Exp Res. 1998; 22: 1796-1802
- Diagnostic interview schedule.Arch Gen Psychiatry. 1981; 38: 1300-1301
- Melatonin and cortisol circadian secretion during ethanol withdrawal in chronic alcoholics.Chronobiologia. 1994; 21: 109-112
- Impaired sleep in alcohol misusers and dependent alcoholics and the impact upon outcome.Alcohol Clin Exp Res. 1999; 23: 1044-1051
- The hypothalamic-pituitary-adrenocortical system and sleep in man.Adv Neuroimmunol. 1995; 5: 111-125
- Improvement of sleep quality in elderly people by controlled-release melatonin.Lancet. 1995; 346: 541-544
- Increased pressure for rapid eye movement sleep at time of hospital admission predicts relapse in nondepressed patients with primary alcoholism at 3-month follow-up.Arch Gen Psychiatry. 1994; 51: 189-197
- Short REM latency in primary alcoholic patients with secondary depression.Am J Psychiatry. 1990; 147: 106-109
- Melatonin effects on sleep, mood and cognition in elderly with mild cognitive impairment.J Pineal Res. 1998; 25: 177-183
- Sleeping and Waking Disorders: Indications and Techniques. Addison-Wesley Medical/Nursing Division, Menlo Park, CA1982
- Melatonin replacement therapy of elderly insomniacs.Sleep. 1995; 18: 598-603
- 24-hour pulsatile and circadian patterns of cortisol secretion in alcoholic men.J Androl. 1989; 10: 54-63
- Polysomnographic and spectral sleep EEG in primary alcoholics.Alcohol Clin Exp Res. 2000; 24: 1376-1384
- Reduction of immune function in life stress and depression.Biol Psychiatry. 1990; 27: 22-30
- Changes in melatonin levels but not cortisol levels are associated with depression in patients with eating disorders.Arch Gen Psychiatry. 1989; 46: 73-78
- Disturbed melatonin secretion in chronic alcoholism and withdrawal.Clin Chem. 1987; 33 ([letter]): 1291
- Pineal function during ethanol intoxication, dependence, and withdrawal.Life Sci. 1986; 39: 2209-2214
- Urine melatonin in alcoholic patients.J Endocrin Invest. 1991; 14: 503-507
- Circadian rhythm of plasma melatonin in endogenous depression.Prog Neuropsychopharmacol Biol Psychiatry. 1984; 8: 715-718
- Plasma melatonin circadian rhythms during the menstrual cycle and after light therapy in premenstrual dysphoric disorder and normal control subjects.J Biol Rhythms. 1997; 12: 47-64
- Effects of sleep and sleep deprivation on interleukin-6, growth hormone, cortisol, and melatonin levels in humans.J Clin Endocrinol Metab. 2000; 85: 3597-3603
- Circadian rhythms of cortisol during alochol withdrawal.Adv Alcohol Subst Abuse. 1988; 7: 37-41
- Disrupted melatonin-secretion during alcohol withdrawal.Prog Neuropsychopharmacol Biol Psychiatry. 1996; 20: 983-995
- The clinical implications of primary diagnostic groups among alcoholics.Arch Gen Psychiatry. 1985; 42: 1043-1049
- Sleep patterns of sober chronic alcoholics.Neuropsychobiology. 1985; 13: 97-100
- Disruption of the diurnal rhythm of plasma melatonin in cirrhosis.Ann Intern Med. 1995; 123: 274-277
- Age, alcoholism and depression are associated with low levels of urinary melatonin.J Psychiatry Neurosci. 1992; 17: 215-224
- Impaired melatonin secretion in patients with Wernicke-Korsakoff syndrome.J Intern Med. 1995; 237: 571-575
- Altered sleep physiology in chronic alcoholics.Alcohol Clin Exp Res. 1981; 5: 318-325
- Sleep-inducing effects of low doses of melatonin ingested in the evening.Clin Pharmacol Ther. 1995; 57: 552-558
- Melatonin treatment for age-related insomnia.J Clin Endocrinol Metab. 2001; 86: 4727-4730
Article info
Publication history
Accepted:
December 16,
2002
Received in revised form:
December 10,
2002
Received:
September 9,
2002
Identification
Copyright
© 2003 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.
