Hubungan Pemberian Melatonin dengan Kualitas Tidur Pasien Stroke Iskemik Fase Akut

Abstract

Background : Sleep disorders increasingly becomes a challenge amongst Ischemic Stroke patients, affected more than 70% of all cases. Previous studies presented a better sleep quality in acute phase of an ischemic stroke were associated to better overall outcome. Melatonin are involved in sleep physiology and recent studies found that it may also have a role in acute ischemia pathophysiology, thus reiterates sleep importance for better outcomes possible in acute ischemic stroke. Objective : To determine the association between Melatonin administration during an acute phase of ischemic stroke patients towards sleep quality. Method : This study used a randomized control trial design with subjects obtained from acute ischemic stroke patients admitted within three different hospitals in Medan, North Sumatra. 32 eligible subjects divided into 2 main groups with simple random sampling method. First group consisted of 16 subjects who received Melatonin 10 mg, once daily for 30 days and the second group consisted of 16 subjects received placebo tablet, once daily for 30 days. No major adverse effect was reported during observation. Results : Sleep quality were measured by The Pittsburgh Sleep Quality Index (PSQI) questionaire at day 1 of admission and at day 30 of the study when subjects returned for routine checkup at Neurology clinic or via telephone for each subject. PSQI global score ≤ 5 indicates good sleep quality while global score > 5 indicates a poor sleep quality.Subjects were mainly male (56,3%), mean age of 59,6 ± 10,8 years and having Batak ethnicity (37,5%). Measurement at day 1 indicated poor sleep quality on both group with PSQI global score 7,9 ± 2,0. Upon completion group who received Melatonin 10 mg once daily marked an improvement in PSQI global score from mean score of 7,8 ± 1,7 at day 1 to mean score of 5,1 ± 2,4 at day 30. No remarkable improvement from Placebo group with similar mean score before and after protocol (8,0 ± 2,4 at day 1 vs 6,9 ± 3,1 at day 30). Conclusion : There is an association between melatonin administration and sleep quality amongst acute ischemic stroke patients