Melatonin associated with improved sleep quality in MS patients

A randomised, double-blind, controlled pilot study demonstrated that melatonin improved sleeping time in MS patients. Sleep disturbances and fatigue may be alleviated by this low-cost, low-risk, over-the-counter supplement [1].

Patients with MS often suffer from sleep disturbances, but therapeutic options targeting sleep in these patients are scarce [2]. A pilot study examined the effect of exogenous melatonin on sleep quality and sleep disturbances in MS patients. Patients with MS and confirmed sleep disturbances (n=30) were randomised 1:1 to a dose-escalating regimen of melatonin (0.5–3 mg, oral, once daily) or placebo for 2 weeks. Patients followed the opposite regimen from weeks 2–4. Sleep time and sleep efficiency were measured with an actigraphy device. Furthermore, several sleep-related patient-reported outcomes (PROs) were recorded. Dr Wan-Yu Hsu (University of California San Francisco, CA, USA) shared the results.

The total sleep time was significantly longer in the melatonin group (mean 6.96 hours) compared with the placebo group (mean 6.67 hours; P=0.03). Moreover, sleep efficiency was numerically higher in melatonin users (84.7%) versus placebo users (83.2%). Mean improvements on the Insomnia Severity Index (ISI) (melatonin -3.5 vs placebo -2.4), the sleep quality component of the Pittsburgh Sleep Quality Index (PSQI) (-0.03 vs 0.0), and the Neuro-Quality of life-Fatigue questionnaire (-4.7 vs -2.4) numerically favoured melatonin users (see Table).

Table: Results of objective outcome measures and PROs in MS patients receiving melatonin or placebo [1]



HADS, Hospital Anxiety and Depression Scale; ESS, Epworth Sleepiness Scale; ISI, Insomnia Severity Index; MSWS-12, Multiple Sclerosis Waling Scale – 12; PROs, patient-reported outcomes; PSQI, Pittsburgh Sleep Quality Index; SEM, standard error of the mean.

1. Hsu W-Y, et al. Effects of melatonin on sleep disturbances in multiple sclerosis: a pilot study. P881, ECTRIMS 2021 Virtual Congress, 13–15 October.
2. Freal JE, et al. Arch Phys Med Rehabil. 1984;65(3):135–8.

 

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Posted on 9 December 202110 December 2021