Melatonin Can Improve Sleep for Patients With Multiple Sclerosis

Sleep quality for patients with multiple sclerosis (MS) could be improved using the over the counter medication melatonin, according to new research published in Multiple Sclerosis Journal.

Sleep disturbance is common for patients with MS.

“These disturbances contribute to chronic symptoms and can exacerbate daytime somnolence and fatigue, which in turn affect patients’ psychological well-being, physical activity, and social and professional capabilities. To date, the optimal management of sleep disturbances is uncertain, and objective studies of sleep quality in PwMS (people with MS) are scarce,” wrote Wan-Yu Hsu, PhD, UCSF Weill Institute for Neurosciences, University of California San Francisco, San Francisco, California, USA, and co-researchers.

Researchers investigated the impact of melatonin use for patients with MS experiencing poor sleep quality and sleep disturbances through this randomized, controlled, double-blind cross-over pilot study.

A total of 30 patients with MS with sleep difficulties were included. Patients were randomized to receive placebo or melatonin for 2 weeks, and then were switched to the opposite treatment arm for an additional 2 weeks.

The primary endpoints were mean total sleep time, sleep quality, and sleep disturbance. A secondary outcome was mean sleep efficiency.

Patients self-reported outcomes on the Insomnia severity index (ISI), Pittsburgh sleep quality index (PSQI), Epworth sleepiness scale (ESS), NeuroQoL-Fatigue questionnaire, Multiple sclerosis walking scale-12 (MSWS-12), and Hospital anxiety and depression scale (HADS) were taken at weeks 0, 2, and 4 while actigraphs were used at weeks 2 and 4 to log mean total sleep efficiency and total sleep time.

Melatonin was associated with statistically significantly improvement in total sleep time. Sleep quality and sleep efficiency scores also improved for patients with MS taking melatonin vs placebo, but not enough to be clinically significant.

Overall, the results support that melatonin may help alleviate sleep disturbances for patients with MS and improve sleep quality.  

“Given the high prevalence of sleep disturbances in PwMS (people with MS) and the long-term health consequences and disease impacts caused by poor sleep, larger studies are needed to unravel the complex relationship between MS and sleep disturbances, as well as develop successful interventions,” concluded Dr Hsu et al.

Hsu WY, Anderson A, Rowles W, et al. Effects of melatonin on sleep disturbances in multiple sclerosis: A randomized, controlled pilot study. Mult Scler J Exp Transl Clin. 2021;7(4):20552173211048756. Published 2021 Nov 5. doi:10.1177/20552173211048756