Insomnia Clinical Trial
Official title:
Relationship of Nocturnal Concentrations of Melatonin, γ-aminobutyric Acid and Total Antioxidants in Peripheral Blood With Insomnia After Stroke: Study Protocol for a Prospective Single-center Randomized Controlled Clinical Trial
To analyze the relationship of nocturnal concentrations of melatonin, γ-aminobutyric acid and total antioxidants with insomnia after stroke.
Sleep disturbance, especially insomnia, is a common complication after ischemic stroke for
the patients during rehabilitation of cerebral infarction. Actually, more than half of
ischemic stroke patients have insomnia complaints. Meanwhile, poor quality of sleep may
greatly impede stroke rehabilitation and induce other complications. Thus, it is of
importance to study the insomnia for the post-stroke patients, especially when they are
during rehabilitation of cerebral infarction.
Melatonin is a pineal hormone with the peak nocturnal secretion. Melatonin typically takes a
large responsibility in coordination with the circadian rhythms and further serves as a
regulator in the sleep function. The secretion peak of melatonin is around midnight to 3:00
a.m.. Along with other antioxidants, the melatonin can also work as an effective
neuroprotective enzyme against neurodegeneration and ischemic brain injury. Thus, the
melatonin is known to take an important role in acute ischemic stroke, with a rhythm
impairment and nocturnal decrease. γ-Aminobutyricacid (GABA) is likewise a strong sleep
regulator that may activate GABA receptors as well as inhibitors of waking processes. It is
known that GABA level in the human body is strongly associated with the impairment of
patients in the acute ischemic stroke. Antioxidant may take a critical role in the balance of
oxidation by scavenging free radicals, so it is regarded as an important marker in studying
the insomnia for the post-stroke patients. However, to our knowledge, there is almost no
report on simultaneous measurements of levels of melatonin, GABA and antioxidants in the
bloods of patients during the convalescence of ischemic stroke or on studying their
association with the insomnia complication for the post-stroke patients.
Therefore, this prospective single-center randomized controlled clinical trial was designed
to investigate the relationship of nocturnal concentrations of melatonin, γ-aminobutyric acid
and total antioxidants with insomnia after stroke by comparing the nocturnal concentrations
of melatonin, GABA and total antioxidants in stroke patients with insomnia or without
insomnia and normal controls.
Data management Clinical researchers accurately, completely, timely filled out the clinical
trial observation form. Data were recorded electronically by data managers using a
double-data entry strategy. The electronic database was locked by the project manager after
checking. All data were analyzed statistically by professional statisticians. Anonymized
trial data will be published at www.figshare.com.
Statistical analysis Data were presented as the mean ± standard deviation for normally
distributed variables, or median values (P25, P75) for non-normally distributed variables.
Student's t-tests or nonparametric Mann-Whitney tests were performed to compare the
differences between normally distributed variables or non-normally distributed variables. For
the analysis of biochemical test results, data were transferred to normal distribution and
Hotelling's T2 tests were performed. Before entering variables into the regression model,
centering predictor variables were performed to avoid nonessential collinearity. Binary
logistic regression analysis was conducted to identify the association between variables or
variables interaction and insomnia diagnosis after infarction. Multiple linear regression
analysis was carried out to determine the correlation between variables or variables
interaction and sleep-related scores, such as Epworth Sleepiness Scale scores, Pittsburgh
Sleep Quality Index scores, Insomnia Severity Index scores, Morningness-Eveningness
Questionnaire (Chinese version) scores and Fatigue Severity Scale scores by using backward
method. P values < 0.05 were considered statistically significant. SPSS 22.0 software was
used for statistical analysis.
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