Effects of melatonin on sleep disturbances in multiple sclerosis: A randomized, controlled pilot study. Issue 4 (October 2021)

• Record Type: Journal Article
• Authors: Hsu, Wan-Yu; Anderson, Annika; Rowles, William; Peters, Katherine E.; Li, Vicki; Stone, Katie L.; Ashbrook, Liza H.; Gelfand, Amy A.; Bove, Riley M.
• Is Part Of: Multiple sclerosis journal, experimental, translational and clinical. Volume 7:Issue 4(2021)
• Publication Date: 2021-10
• Subjects: melatonin -- multiple sclerosis -- sleep disturbance -- sleep quality -- actigraph -- patient-reported outcomes; Multiple sclerosis -- Periodicals; 616.834
• DOI: 10.1177/20552173211048756
• Languages: English
• ISSNs: 2055-2173

Abstract

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