Sleep hormone could save lives and money

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Ramsay Health Care’s Joondalup Health Campus is likely to be a trial site for a new hormone supplement that could save the Western Australian Government millions of dollars each year – not to mention save lives.

A new study is seeking to prove that giving intensive care patients pills containing the sleep hormone melatonin could reduce the delirium that up to 80 per cent of patients suffer.

The randomised, ‘blinded’, placebo-controlled trial on 840 patient volunteers will occur over the next 12-18 months.

Joondalup has been earmarked as a potential trial site, while Sir Charles Gairdner Hospital, Royal Perth Hospital, Fiona Stanley Hospital and John Hunter Hospital in New South Wales will also be used.

Sir Charles Gairdner Hospital intensivist Bradley Wibrow is the principal researcher of the study.

He said previous studies showed that up to 80 per cent of patients in Western Australia’s intensive care units (ICU) suffered from delirium, which is linked to higher mortality rates as well as increased length of stay in the ICU.

It is generally accepted that a delirious patient will spend at least half a day longer in ICU.

When it costs $5,534 per day to keep a patient in intensive care, shortening stays could save significant amounts of money.

Dr Wibrow said the ICU environment, dark in the daytime and full of noise and bright lights at night, made delirium worse.

“The factors associated are decreased quality and duration of sleep,” he told Fairfax Media.

“It’s a really big problem and there has been more and more focus on it for the past five to 10 years in intensive care literature.”

Light fading at the end of the day normally triggers the brain to produce the sleep-inducing hormone melatonin.

But Dr Wibrow said previous studies on ICU patients had showed they had melatonin deficiency.

Melatonin supplements have been used in limited studies before and in wards for treatment purposes, but never as a preventive measure and never in ICUs.

Dr Wibrow said it is different to sleeping pills because it isn’t addictive and patients aren’t able to build up a tolerance against it.

“It’s not that difficult to actually create and you can generally buy it easily. It’s still manufactured, but it’s the same hormone that’s produced by the body,” he said.

“If it does work it would be good because there are not many medical treatments to prevent delirium. Antipsychotics have significant side effects so giving any drug to a patient already experiencing side effects is not ideal.”

Melatonin is cheap, with a patient’s daily dose estimated at costing about 85 cents. Giving it to ICU patients in Western Australia for the length of their stay would cost less than $15,800 per year.

“This is by far the biggest study ever done on melatonin and this will hopefully give us the definitive answer,” Dr Wibrow said.

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