Correspondence: circadian melatonin rhythms in critically ill patients with delirium
By
Danielle Hunziker
Tatjana Zehnder
Madlaina Forster
Anna Estermann
Núria Zellweger
Jan Huber
Andrea Blum
Salim Abdelhamid
Fenna Stolte
Lua Maria Mengisen
Christian Cajochen
Vitaliy Kolodyazhniy
Martin Siegemund
Alexa Hollinger
April 10, 2026
Clinical Scorecard: Circadian Melatonin Patterns in Critically Ill Patients Experiencing Delirium
At a Glance
Category Detail
Condition Delirium in critically ill patients Key Mechanisms Circadian rhythm disruption and altered melatonin secretion Target Population Critically ill patients in Intensive Care Units (ICU) Care Setting Mixed ICU of a tertiary care center
Key Highlights
Delirium rates in ICU can be as high as 80%. Delirious patients show significant delays in melatonin onset and midpoint time. Higher SOFA scores correlate with delayed melatonin midpoint time. Melatonin treatment may help normalize circadian rhythms and prevent delirium. Findings suggest the need for further research on melatonin's role in delirium. Guideline-Based Recommendations
Diagnosis
Use the Intensive Care Delirium Screening Checklist (ICDSC) for diagnosis. Management
Consider timed intake of melatonin or its analogues for delirium prevention. Monitoring & Follow-up
Measure plasma melatonin levels every two hours for accurate assessment. Risks
Potential disruption of sleep due to frequent blood sampling. Patient & Prescribing Data
Critically ill patients with varying medical histories.
Melatonin profiles differ significantly between delirious and non-delirious patients.
Clinical Best Practices
Utilize advanced mathematical approaches for analyzing melatonin profiles. Monitor circadian rhythms closely in critically ill patients. Related Resources & Content
