Rest-activity disturbances in children with septo-optic dysplasia characterized by actigraphy and 24-hour plasma melatonin profiles.

Abstract

INTRODUCTION:

A trial of melatonin treatment in children with septo-optic dysplasia (SOD) and sleep disruption is accepted clinical practice in many centers. However, no objective measurements of sleep/activity patterns with 24-h melatonin profiles have been published for these individuals, and the pathophysiological basis underlying sleep disorders in SOD remains largely unknown.

METHODS:

We studied six children with rest-activity disturbances and SOD. All wore an Actiwatch-Mini (a noninvasive method of detecting and recording movement intensity) for 2 wk and were admitted to hospital for a 24-h period during which hourly measurements of serum melatonin were taken. Sleep data were analyzed in conjunction with a detailed sleep diary. Ethical approval was obtained for these studies.

RESULTS:

Two children produced virtually no melatonin throughout the 24-h period of measurement and had fragmented sleep patterns with no evidence of a non-24-h sleep-wake disorder or delayed sleep-phase disorder. One child had a normal melatonin profile despite actigraphy showing an arrhythmic sleep pattern. The remaining three children had fragmented sleep, with two having normal melatonin profiles and one having a modest increase in daytime melatonin concentrations, making the timing of dim-light melatonin onset difficult to discern.

CONCLUSIONS:

There is considerable variation in timing and amount of melatonin secretion in these children. Surprisingly, none of the children had either actigraphic or melatonin profile evidence of a non-24-h sleep-wake disorder or delayed sleep-phase disorder. Understanding the heterogeneous nature of underlying sleep disorders in this group of children is important and has implications for their management.

• Authors: E A Webb, M A O'Reilly, J Orgill, N Dale, A Salt, P Gringras, M T Dattani
• Journal: The Journal of clinical endocrinology and metabolism (J Clin Endocrinol Metab) Vol. 95 Issue 10 Pg. E198-203 (Oct 2010) ISSN: 1945-7197 [Electronic] United States
• PMID: 20660044 (Publication Type: Controlled Clinical Trial, Journal Article)

Chemical References

• Melatonin

Topics

• Actigraphy (methods)
• Activity Cycles (physiology)
• Child
• Child, Preschool
• Chronobiology Disorders (blood, complications, diagnosis, physiopathology)
• Circadian Rhythm
• Diagnostic Techniques, Endocrine
• Female
• Humans
• Infant
• Male
• Melatonin (analysis, blood, metabolism)
• Metabolome
• Rest (physiology)
• Septo-Optic Dysplasia (blood, complications, diagnosis, physiopathology)