Evaluation of Exogenous Melatonin Administration in Improvement of Sleep Quality in Patients with Chronic Obstructive Pulmonary Disease

Background: COPD is primarily the disease of the lungs; nevertheless, multiple systemic manifestations including poor sleep quality and sleep disturbances have been linked to this illness. Administration of sedative hypnotics is not recommended in COPD patients, as these drugs suppress the ventilatory response and exacerbate sleep-related disorders. Melatonin is an alternative medication that has been widely used to treat sleep disturbances caused by aging and other specific conditions. We aimed to investigate the efficacy of melatonin administration in improvement of sleep quality in COPD patients. Materials and Methods: A randomized, double-blind, placebo-controlled trial was conducted. A total of 54 patients were recruited and randomly assigned into either melatonin or placebo group. Sleep quality was evaluated by Pittsburgh Sleep Quality Index (PSQI); daytime sleepiness was assessed by Epworth Sleepiness Scale (ESS). For all patients, spirometry and pulse oximetry were preformed to evaluate lung function and oxygenation. Results: Compared with placebo, melatonin administration significantly improved global PSQI score (p < 0.001). Of PSQI individual components, sleep quality (p=0.001), sleep latency (p=0.001), sleep efficacy (p=0.003), and sleep duration (p=0.024) improved significantly. On the other hand, melatonin treatment did not significantly change indices of daytime sleepiness, lung function and oxygenation (p > 0.05). Conclusion: Melatonin significantly improves sleep quality in COPD patients with sleep complaints. This improvement was in the absence of significant elevation in the indices of daytime sleepiness and lung function.