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. 2006 Feb;44(2):78-81.
doi: 10.1038/sj.sc.3101784.

Reduced sleep efficiency in cervical spinal cord injury; association with abolished night time melatonin secretion

F A J L Scheer  1 , J M Zeitzer, N T Ayas, R Brown, C A Czeisler, S A Shea
Affiliations

Reduced sleep efficiency in cervical spinal cord injury; association with abolished night time melatonin secretion

F A J L Scheer et al. Spinal Cord. 2006 Feb.

Abstract

Study design: Case-controlled preliminary observational study.

Objective: Melatonin is usually secreted only at night and may influence sleep. We previously found that complete cervical spinal cord injury (SCI) interrupts the neural pathway required for melatonin secretion. Thus, we investigated whether the absence of night time melatonin in cervical SCI leads to sleep disturbances.

Setting: General Clinical Research Center, Brigham and Women's Hospital, Boston, USA.

Methods: In an ancillary analysis of data collected in a prior study, we assessed the sleep patterns of three subjects with cervical SCI plus absence of nocturnal melatonin (SCI levels: C4A, C6A, C6/7A) and two control patients with thoracic SCI plus normal melatonin rhythms (SCI levels: T4A, T5A). We also compared those results to the sleep patterns of 10 healthy control subjects.

Results: The subjects with cervical SCI had significantly lower sleep efficiency (median 83%) than the control subjects with thoracic SCI (93%). The sleep efficiency of subjects with thoracic SCI was not different from that of healthy control subjects (94%). There was no difference in the proportion of the different sleep stages, although there was a significantly increased REM-onset latency in subjects with cervical SCI (220 min) as compared to subjects with thoracic SCI (34 min). The diminished sleep in cervical SCI was not associated with sleep apnea or medication use.

Conclusion: We found that cervical SCI is associated with decreased sleep quality. A larger study is required to confirm these findings. If confirmed, the absence of night time melatonin in cervical SCI may help explain their sleep disturbances, raising the possibility that melatonin replacement therapy could help normalize sleep in this group.

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Figures

Figure 1
Figure 1
The 24 h average melatonin plasma concentration and sleep variables compared between healthy controls, patients with thoracic SCI and a clear night time melatonin surge, and patients with cervical SCI and no night time melatonin surge. For the healthy controls (C), the box indicates the IQR and the horizontal line within the box indicates the median. Subject codes are indicated for cross-reference
See this image and copyright information in PMC

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