423. RAMELTEON REDUCED ANXIETY/DEPRESSION AND SLEEP PROBLEMS AMONG SHIFT WORKERS

Abstract Background Circadian rhythm sleep disorder and anxiety/depression are often seen in shift-time workers. Aims & Objectives The study aimed to identify the anxiety/depressive, and stress related autonomic nervous system dysregulation among shift-time nurses. The study aimed to identify the anxiety/depressive, and stress related autonomic nervous system dysregulation among shift-time nurses. The effectiveness of interventions with melatonin agonist for their sleep quality, fatigue, anxiety/depression were evaluated. Method We provided melatonin agonist ramelteon for 61 subjects who agreed to participate and meet the DSM-5 diagnostic criteria of this Circadian Rhythm Sleep Wake Disorders. They received the assessments including questionnaires Pittsburgh Sleep Quality Index, The Epworth Sleepiness Scale, Beck’s Anxiety Inventory, Beck’s Depression Inventory, and heart rate variability before and after supplement with ramelteon 8mg for 2 weeks to investigate the effectiveness and safety. Results The anxiety symptoms severity was associated with sleep quality, tiredness, depression symptom severity among shift-time workers. The tiredness symptoms were significantly correlated with autonomous nervous function Ln LF/HF which represent sympathetic/parasympathetic nerve activity ratio. The anxiety, depression, tiredness symptoms severity as well as sleep quality improved after treatment with melatonin agonist Ramelteon for two weeks. However, there was a direct effect of relationship between improvement of anxiety and sleep quality which was not mediated by improvement of tiredness. Discussion & Conclusions Our preliminary open-label trial was the first to show ramelteon, a pure melatonin agonist, could reduce both anxiety/depression and sleep quality. The circadian rhythm might play a role of the presence of anxiety/depression among shift workers. The circadian rhythm and mental condition of shift workers can be regularly monitored and evaluated. Melatonin agonist might aid in the intervention for both sleep quality and anxiety/depression. The medicine could be designed for the future trials for the reduction of mental symptoms of shift worker. It might served as an alternative treatment for benzodiapine to avoid cognitive related functional impairments since they are working in a disturbed circadian rhythm which is a highly stress situation.