Sleep disruption in tetraplegia: a randomised, double-blind, placebo-controlled crossover trial of 3 mg melatonin
Study design: Randomised, double-blind, placebo-controlled crossover trial of melatonin supplementation to people with complete tetraplegia. Objectives: To investigate the effect that 3 mg melatonin supplementation has on objective and subjective sleep, quality of life and mood of people living with...
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| Veröffentlicht in: | Spinal cord 2014-08, Vol.52 (8), p.629-634 |
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| creator | Spong, J Kennedy, G A Tseng, J Brown, D J Armstrong, S Berlowitz, D J |
| description | Study design:
Randomised, double-blind, placebo-controlled crossover trial of melatonin supplementation to people with complete tetraplegia.
Objectives:
To investigate the effect that 3 mg melatonin supplementation has on objective and subjective sleep, quality of life and mood of people living with complete tetraplegia.
Setting:
Austin Hospital Sleep Laboratory and participants’ homes, Melbourne, Victoria, Australia.
Methods:
Two week run-in followed by 3 week nightly administration of 3 mg melatonin or placebo, 2-week washout and further 3 week administration of the opposite treatment. Four testing sessions were conducted; the last nights of the run-in, treatment and washout periods. Testing sessions involved recording full polysomnography, completing a questionnaire battery and collecting urine and blood samples. The questionnaires assessed mood, sleep symptoms and health-related quality of life, and the urine and plasma samples assayed 6-sulphatoxymelatonin (aMT6s) and melatonin levels, respectively. A sleep diary was completed throughout the study.
Results:
Eight participants (mean (s.d.): age 49.5 years (16), postinjury 16.9 years (7.1)) were recruited in which seven concluded the protocol. Endogenous-circulating melatonin was significantly higher (
P
⩽0.01) following melatonin (urine: 152.94 μg h
−1
(74.51), plasma: 43 554.57 pM (33 527.11)) than placebo (urine: 0.86 μg h
−1
(0.40), plasma: 152.06 pM (190.55)). Subjective sleep improved significantly following melatonin specifically for duration of sleep per night and psychological wellbeing. Objective sleep showed a significant increase in light sleep with melatonin, with all other sleep parameters being unchanged.
Conclusion:
These results suggest that increasing melatonin in people with complete tetraplegia is beneficial, especially for subjective sleep. Investigation of the pharmacokinetics of melatonin metabolism in this population is warranted.
Sponsorship:
This project is proudly supported by the Transport Accident Commission. |
| doi_str_mv | 10.1038/sc.2014.84 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1622612740</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1622612740</sourcerecordid><originalsourceid>FETCH-LOGICAL-c453t-bb32e1aeae34ccd48fd221bbaf569d8a024fd3ca37f921ed109df5056d08c3623</originalsourceid><addsrcrecordid>eNqFkc1u1TAQhS1ERX9gwwMgS2xQIbfjn-Q67FAFpVKlLkrXkWNPrlw5drATJHZs-5p9Enx7C6pg0dXMaD6d0ZlDyGsGKwZCnWSz4sDkSsln5IDJdVPVDZfPSy8aXknRin1ymPMNALSsVS_IPpeqZQDrA5KvPOJErctpmWYXA3WBzjgnPXncOP2Rapp0sHF0Ge0HauPSe6x670KZJq8N9rEyMcwpeo-WmhRzjj8w0Tk57WkcqLj7dTtu6IhezzG48JLsDdpnfPVQj8j1l8_fTr9WF5dn56efLiojazFXfS84Mo0ahTTGSjVYzlnf66FuWqs0cDlYYbRYDy1naBm0dqihbiwoU5yLI_Jupzul-H3BPHfFhEHvdcC45I41nDeMryU8jdY1Ay5ELQv69h_0Ji4pFCNbCpgABW2hjnfU_T8SDt2U3KjTz45Bt02ty6bbptapreSbB8mlH9H-Rf_EVID3OyCXVdhgenTzf7nfKPWh9Q</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1550130809</pqid></control><display><type>article</type><title>Sleep disruption in tetraplegia: a randomised, double-blind, placebo-controlled crossover trial of 3 mg melatonin</title><source>MEDLINE</source><source>EZB-FREE-00999 freely available EZB journals</source><creator>Spong, J ; Kennedy, G A ; Tseng, J ; Brown, D J ; Armstrong, S ; Berlowitz, D J</creator><creatorcontrib>Spong, J ; Kennedy, G A ; Tseng, J ; Brown, D J ; Armstrong, S ; Berlowitz, D J</creatorcontrib><description>Study design:
Randomised, double-blind, placebo-controlled crossover trial of melatonin supplementation to people with complete tetraplegia.
Objectives:
To investigate the effect that 3 mg melatonin supplementation has on objective and subjective sleep, quality of life and mood of people living with complete tetraplegia.
Setting:
Austin Hospital Sleep Laboratory and participants’ homes, Melbourne, Victoria, Australia.
Methods:
Two week run-in followed by 3 week nightly administration of 3 mg melatonin or placebo, 2-week washout and further 3 week administration of the opposite treatment. Four testing sessions were conducted; the last nights of the run-in, treatment and washout periods. Testing sessions involved recording full polysomnography, completing a questionnaire battery and collecting urine and blood samples. The questionnaires assessed mood, sleep symptoms and health-related quality of life, and the urine and plasma samples assayed 6-sulphatoxymelatonin (aMT6s) and melatonin levels, respectively. A sleep diary was completed throughout the study.
Results:
Eight participants (mean (s.d.): age 49.5 years (16), postinjury 16.9 years (7.1)) were recruited in which seven concluded the protocol. Endogenous-circulating melatonin was significantly higher (
P
⩽0.01) following melatonin (urine: 152.94 μg h
−1
(74.51), plasma: 43 554.57 pM (33 527.11)) than placebo (urine: 0.86 μg h
−1
(0.40), plasma: 152.06 pM (190.55)). Subjective sleep improved significantly following melatonin specifically for duration of sleep per night and psychological wellbeing. Objective sleep showed a significant increase in light sleep with melatonin, with all other sleep parameters being unchanged.
Conclusion:
These results suggest that increasing melatonin in people with complete tetraplegia is beneficial, especially for subjective sleep. Investigation of the pharmacokinetics of melatonin metabolism in this population is warranted.
Sponsorship:
This project is proudly supported by the Transport Accident Commission.</description><identifier>ISSN: 1362-4393</identifier><identifier>EISSN: 1476-5624</identifier><identifier>DOI: 10.1038/sc.2014.84</identifier><identifier>PMID: 24891007</identifier><identifier>CODEN: SPCOFM</identifier><language>eng</language><publisher>London: Nature Publishing Group UK</publisher><subject>692/308/409 ; Adult ; Affect - drug effects ; Aged ; Anatomy ; Antioxidants - metabolism ; Antioxidants - therapeutic use ; Biomedical and Life Sciences ; Biomedicine ; Cross-Over Studies ; Double-Blind Method ; Female ; Human Physiology ; Humans ; Male ; Melatonin - analogs & derivatives ; Melatonin - blood ; Melatonin - therapeutic use ; Melatonin - urine ; Middle Aged ; Neurochemistry ; Neuropsychology ; Neurosciences ; original-article ; Polysomnography ; Quadriplegia - complications ; Quadriplegia - drug therapy ; Quadriplegia - psychology ; Quality of Life ; Sleep Wake Disorders - blood ; Sleep Wake Disorders - drug therapy ; Sleep Wake Disorders - etiology ; Sleep Wake Disorders - urine ; Surveys and Questionnaires</subject><ispartof>Spinal cord, 2014-08, Vol.52 (8), p.629-634</ispartof><rights>International Spinal Cord Society 2014</rights><rights>Copyright Nature Publishing Group Aug 2014</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c453t-bb32e1aeae34ccd48fd221bbaf569d8a024fd3ca37f921ed109df5056d08c3623</citedby><cites>FETCH-LOGICAL-c453t-bb32e1aeae34ccd48fd221bbaf569d8a024fd3ca37f921ed109df5056d08c3623</cites><orcidid>0000-0003-2543-8722 ; 0000000325438722</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>315,781,785,27929,27930</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/24891007$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Spong, J</creatorcontrib><creatorcontrib>Kennedy, G A</creatorcontrib><creatorcontrib>Tseng, J</creatorcontrib><creatorcontrib>Brown, D J</creatorcontrib><creatorcontrib>Armstrong, S</creatorcontrib><creatorcontrib>Berlowitz, D J</creatorcontrib><title>Sleep disruption in tetraplegia: a randomised, double-blind, placebo-controlled crossover trial of 3 mg melatonin</title><title>Spinal cord</title><addtitle>Spinal Cord</addtitle><addtitle>Spinal Cord</addtitle><description>Study design:
Randomised, double-blind, placebo-controlled crossover trial of melatonin supplementation to people with complete tetraplegia.
Objectives:
To investigate the effect that 3 mg melatonin supplementation has on objective and subjective sleep, quality of life and mood of people living with complete tetraplegia.
Setting:
Austin Hospital Sleep Laboratory and participants’ homes, Melbourne, Victoria, Australia.
Methods:
Two week run-in followed by 3 week nightly administration of 3 mg melatonin or placebo, 2-week washout and further 3 week administration of the opposite treatment. Four testing sessions were conducted; the last nights of the run-in, treatment and washout periods. Testing sessions involved recording full polysomnography, completing a questionnaire battery and collecting urine and blood samples. The questionnaires assessed mood, sleep symptoms and health-related quality of life, and the urine and plasma samples assayed 6-sulphatoxymelatonin (aMT6s) and melatonin levels, respectively. A sleep diary was completed throughout the study.
Results:
Eight participants (mean (s.d.): age 49.5 years (16), postinjury 16.9 years (7.1)) were recruited in which seven concluded the protocol. Endogenous-circulating melatonin was significantly higher (
P
⩽0.01) following melatonin (urine: 152.94 μg h
−1
(74.51), plasma: 43 554.57 pM (33 527.11)) than placebo (urine: 0.86 μg h
−1
(0.40), plasma: 152.06 pM (190.55)). Subjective sleep improved significantly following melatonin specifically for duration of sleep per night and psychological wellbeing. Objective sleep showed a significant increase in light sleep with melatonin, with all other sleep parameters being unchanged.
Conclusion:
These results suggest that increasing melatonin in people with complete tetraplegia is beneficial, especially for subjective sleep. Investigation of the pharmacokinetics of melatonin metabolism in this population is warranted.
Sponsorship:
This project is proudly supported by the Transport Accident Commission.</description><subject>692/308/409</subject><subject>Adult</subject><subject>Affect - drug effects</subject><subject>Aged</subject><subject>Anatomy</subject><subject>Antioxidants - metabolism</subject><subject>Antioxidants - therapeutic use</subject><subject>Biomedical and Life Sciences</subject><subject>Biomedicine</subject><subject>Cross-Over Studies</subject><subject>Double-Blind Method</subject><subject>Female</subject><subject>Human Physiology</subject><subject>Humans</subject><subject>Male</subject><subject>Melatonin - analogs & derivatives</subject><subject>Melatonin - blood</subject><subject>Melatonin - therapeutic use</subject><subject>Melatonin - urine</subject><subject>Middle Aged</subject><subject>Neurochemistry</subject><subject>Neuropsychology</subject><subject>Neurosciences</subject><subject>original-article</subject><subject>Polysomnography</subject><subject>Quadriplegia - complications</subject><subject>Quadriplegia - drug therapy</subject><subject>Quadriplegia - psychology</subject><subject>Quality of Life</subject><subject>Sleep Wake Disorders - blood</subject><subject>Sleep Wake Disorders - drug therapy</subject><subject>Sleep Wake Disorders - etiology</subject><subject>Sleep Wake Disorders - urine</subject><subject>Surveys and Questionnaires</subject><issn>1362-4393</issn><issn>1476-5624</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2014</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><recordid>eNqFkc1u1TAQhS1ERX9gwwMgS2xQIbfjn-Q67FAFpVKlLkrXkWNPrlw5drATJHZs-5p9Enx7C6pg0dXMaD6d0ZlDyGsGKwZCnWSz4sDkSsln5IDJdVPVDZfPSy8aXknRin1ymPMNALSsVS_IPpeqZQDrA5KvPOJErctpmWYXA3WBzjgnPXncOP2Rapp0sHF0Ge0HauPSe6x670KZJq8N9rEyMcwpeo-WmhRzjj8w0Tk57WkcqLj7dTtu6IhezzG48JLsDdpnfPVQj8j1l8_fTr9WF5dn56efLiojazFXfS84Mo0ahTTGSjVYzlnf66FuWqs0cDlYYbRYDy1naBm0dqihbiwoU5yLI_Jupzul-H3BPHfFhEHvdcC45I41nDeMryU8jdY1Ay5ELQv69h_0Ji4pFCNbCpgABW2hjnfU_T8SDt2U3KjTz45Bt02ty6bbptapreSbB8mlH9H-Rf_EVID3OyCXVdhgenTzf7nfKPWh9Q</recordid><startdate>20140801</startdate><enddate>20140801</enddate><creator>Spong, J</creator><creator>Kennedy, G A</creator><creator>Tseng, J</creator><creator>Brown, D J</creator><creator>Armstrong, S</creator><creator>Berlowitz, D J</creator><general>Nature Publishing Group UK</general><general>Nature Publishing Group</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QL</scope><scope>7RV</scope><scope>7T7</scope><scope>7TK</scope><scope>7U9</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FD</scope><scope>8FE</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BHPHI</scope><scope>C1K</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>H94</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB0</scope><scope>LK8</scope><scope>M0S</scope><scope>M1P</scope><scope>M7N</scope><scope>M7P</scope><scope>NAPCQ</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-2543-8722</orcidid><orcidid>https://orcid.org/0000000325438722</orcidid></search><sort><creationdate>20140801</creationdate><title>Sleep disruption in tetraplegia: a randomised, double-blind, placebo-controlled crossover trial of 3 mg melatonin</title><author>Spong, J ; Kennedy, G A ; Tseng, J ; Brown, D J ; Armstrong, S ; Berlowitz, D J</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c453t-bb32e1aeae34ccd48fd221bbaf569d8a024fd3ca37f921ed109df5056d08c3623</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2014</creationdate><topic>692/308/409</topic><topic>Adult</topic><topic>Affect - drug effects</topic><topic>Aged</topic><topic>Anatomy</topic><topic>Antioxidants - metabolism</topic><topic>Antioxidants - therapeutic use</topic><topic>Biomedical and Life Sciences</topic><topic>Biomedicine</topic><topic>Cross-Over Studies</topic><topic>Double-Blind Method</topic><topic>Female</topic><topic>Human Physiology</topic><topic>Humans</topic><topic>Male</topic><topic>Melatonin - analogs & derivatives</topic><topic>Melatonin - blood</topic><topic>Melatonin - therapeutic use</topic><topic>Melatonin - urine</topic><topic>Middle Aged</topic><topic>Neurochemistry</topic><topic>Neuropsychology</topic><topic>Neurosciences</topic><topic>original-article</topic><topic>Polysomnography</topic><topic>Quadriplegia - complications</topic><topic>Quadriplegia - drug therapy</topic><topic>Quadriplegia - psychology</topic><topic>Quality of Life</topic><topic>Sleep Wake Disorders - blood</topic><topic>Sleep Wake Disorders - drug therapy</topic><topic>Sleep Wake Disorders - etiology</topic><topic>Sleep Wake Disorders - urine</topic><topic>Surveys and Questionnaires</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Spong, J</creatorcontrib><creatorcontrib>Kennedy, G A</creatorcontrib><creatorcontrib>Tseng, J</creatorcontrib><creatorcontrib>Brown, D J</creatorcontrib><creatorcontrib>Armstrong, S</creatorcontrib><creatorcontrib>Berlowitz, D J</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Nursing & Allied Health Database</collection><collection>Industrial and Applied Microbiology Abstracts (Microbiology A)</collection><collection>Neurosciences Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Technology Research Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Natural Science Collection (ProQuest)</collection><collection>Environmental Sciences and Pollution Management</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>ProQuest Biological Science Collection</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>Biological Science Database</collection><collection>Nursing & Allied Health Premium</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Spinal cord</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Spong, J</au><au>Kennedy, G A</au><au>Tseng, J</au><au>Brown, D J</au><au>Armstrong, S</au><au>Berlowitz, D J</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Sleep disruption in tetraplegia: a randomised, double-blind, placebo-controlled crossover trial of 3 mg melatonin</atitle><jtitle>Spinal cord</jtitle><stitle>Spinal Cord</stitle><addtitle>Spinal Cord</addtitle><date>2014-08-01</date><risdate>2014</risdate><volume>52</volume><issue>8</issue><spage>629</spage><epage>634</epage><pages>629-634</pages><issn>1362-4393</issn><eissn>1476-5624</eissn><coden>SPCOFM</coden><abstract>Study design:
Randomised, double-blind, placebo-controlled crossover trial of melatonin supplementation to people with complete tetraplegia.
Objectives:
To investigate the effect that 3 mg melatonin supplementation has on objective and subjective sleep, quality of life and mood of people living with complete tetraplegia.
Setting:
Austin Hospital Sleep Laboratory and participants’ homes, Melbourne, Victoria, Australia.
Methods:
Two week run-in followed by 3 week nightly administration of 3 mg melatonin or placebo, 2-week washout and further 3 week administration of the opposite treatment. Four testing sessions were conducted; the last nights of the run-in, treatment and washout periods. Testing sessions involved recording full polysomnography, completing a questionnaire battery and collecting urine and blood samples. The questionnaires assessed mood, sleep symptoms and health-related quality of life, and the urine and plasma samples assayed 6-sulphatoxymelatonin (aMT6s) and melatonin levels, respectively. A sleep diary was completed throughout the study.
Results:
Eight participants (mean (s.d.): age 49.5 years (16), postinjury 16.9 years (7.1)) were recruited in which seven concluded the protocol. Endogenous-circulating melatonin was significantly higher (
P
⩽0.01) following melatonin (urine: 152.94 μg h
−1
(74.51), plasma: 43 554.57 pM (33 527.11)) than placebo (urine: 0.86 μg h
−1
(0.40), plasma: 152.06 pM (190.55)). Subjective sleep improved significantly following melatonin specifically for duration of sleep per night and psychological wellbeing. Objective sleep showed a significant increase in light sleep with melatonin, with all other sleep parameters being unchanged.
Conclusion:
These results suggest that increasing melatonin in people with complete tetraplegia is beneficial, especially for subjective sleep. Investigation of the pharmacokinetics of melatonin metabolism in this population is warranted.
Sponsorship:
This project is proudly supported by the Transport Accident Commission.</abstract><cop>London</cop><pub>Nature Publishing Group UK</pub><pmid>24891007</pmid><doi>10.1038/sc.2014.84</doi><tpages>6</tpages><orcidid>https://orcid.org/0000-0003-2543-8722</orcidid><orcidid>https://orcid.org/0000000325438722</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
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| ispartof | Spinal cord, 2014-08, Vol.52 (8), p.629-634 |
| issn | 1362-4393 1476-5624 |
| language | eng |
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| source | MEDLINE; EZB-FREE-00999 freely available EZB journals |
| subjects | 692/308/409 Adult Affect - drug effects Aged Anatomy Antioxidants - metabolism Antioxidants - therapeutic use Biomedical and Life Sciences Biomedicine Cross-Over Studies Double-Blind Method Female Human Physiology Humans Male Melatonin - analogs & derivatives Melatonin - blood Melatonin - therapeutic use Melatonin - urine Middle Aged Neurochemistry Neuropsychology Neurosciences original-article Polysomnography Quadriplegia - complications Quadriplegia - drug therapy Quadriplegia - psychology Quality of Life Sleep Wake Disorders - blood Sleep Wake Disorders - drug therapy Sleep Wake Disorders - etiology Sleep Wake Disorders - urine Surveys and Questionnaires |
| title | Sleep disruption in tetraplegia: a randomised, double-blind, placebo-controlled crossover trial of 3 mg melatonin |
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