Effects of melatonin on sleep disturbances in multiple sclerosis. - GreenMedInfo Summary

Background: Sleep disturbances are commonly reported by people with multiple sclerosis (PwMS). However, optimal management of sleep disturbances is uncertain, and objective studies of sleep quality in PwMS are scarce.

Objectives: To determine the effect of exogenous melatonin on sleep quality and sleep disturbances in PwMS.

Methods: Thirty adult PwMS reporting sleep difficulties were recruited in a randomized, controlled, double-blind cross-over study. They took either melatonin or placebo for 2 weeks, and the opposite for the following 2 weeks. During weeks 2 and 4, an actigraph was used to capture mean total sleep time and sleep efficiency. Patient-reported outcomes (PROs) were collected at weeks 0, 2 and 4.

Results: Melatonin use significantly improved mean total sleep time ( = 0.03), with a trend towards higher sleep efficiency ( = 0.06). No PROs were significantly different; there was a trend for melatonin use to decrease mean Insomnia Severity Index score ( = 0.07), improve Pittsburgh Sleep Quality Index sleep quality component ( = 0.07), and improve NeuroQoL-Fatigue ( = 0.06). No other PROs showed differences between melatonin and placebo; nor did step count measured by actigraphy (all > 0.45).

Conclusion: These results provide preliminary evidence that melatonin, a low-cost, over-the-counter supplement, could improve objective measures of sleep quality in PwMS.