Effect of Melatonin on Sleep in the Perioperative Period after Breast Cancer Surgery: A Randomized, Double-Blind, Placebo-Controlled Trial

Madsen, Michael Tvilling; Hansen, Melissa Voigt; Andersen, Lærke Toftegård; Hageman, Ida; Rasmussen, Lars S.; Bokmand, Susanne; Rosenberg, Jacob; Gögenür, Ismail

doi:10.5664/jcsm.5490

Cited by 42 publications

(51 citation statements)

References 42 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Three melatonin studies assessed sleep continuity through actigraphy. Whereas Hansen et al . found statistically significant differences regarding sleep efficiency and WASO for POD1–6 (eg, for POD1–3 sleep efficiency [median (range)] 96.4 (78.4 to 100) (melatonin) vs. 92.5 (83.1 to 100) (placebo) %, P = 0.016; WASO 17 (0 to 128) minutes (melatonin) vs. 32 (0 to 102) minutes (placebo), P = 0.035), sleep efficiency was strikingly high for both groups, particularly considering the perioperative setting.…”

Section: Resultsmentioning

confidence: 88%

Perioperative Pharmacological Sleep‐Promotion and Pain Control: A Systematic Review

Bjurström

Irwin

2019

Pain Practice

View full text Add to dashboard Cite

Background: Sleep macrostructure is commonly disturbed after surgery. Postoperative pain control remains challenging. Given the bidirectional interaction between sleep and pain, understanding the role of modulation of sleep during the perioperative period on postoperative pain is needed. Methods: This was a systematic review. Controlled trials examining the effects of perioperative sleep-promoting pharmacological agents on postoperative pain and analgesic consumption were identified through a systematic search strategy utilizing multiple electronic databases. Results: Fourteen studies (9 melatonin, 5 zolpidem) involving 921 patients (melatonin n = 586, zolpidem n = 335) were included. Compared to placebo, melatonin reduced postoperative pain scores by ≥30% and significantly decreased opioid consumption in 3 studies (postoperative day [POD]

show abstract

Section: Resultsmentioning

confidence: 88%

Perioperative Pharmacological Sleep‐Promotion and Pain Control: A Systematic Review

Bjurström

Irwin

2019

Pain Practice

View full text Add to dashboard Cite

show abstract

“…A recent study conducted on 32 metastatic breast cancer patients who took 5 mg/day of melatonin for two months at bedtime showed a reduction in sleep fragmentation ( p = 0,0015) and an increase in sleep duration [ 61 ]. Similarly, a double-blind, placebo-controlled, randomized study among breast cancer patients comparing 6 mg/day of melatonin ( n = 27) to placebo ( n = 21), from three nights before surgery until one week post-surgery, showed an increase in sleep efficacy in the melatonin group ( p = 0,007) and a reduction in waking-after-sleep onset [ 62 ]. Also according to the above-mentioned meta-analysis [ 22 , 23 ], melatonin significantly reduces symptoms such as asthenia, leukopenia, nausea and vomiting, hypotension, and thrombocytopenia.…”

Section: Methodsmentioning

confidence: 99%

“…Furthermore, in the studies, the dosage of melatonin varies from 5 mg/day to 20 mg/day while standard dosage of sustained-release formulation is 2 mg/day ( Table 1). The smaller dosages lead to good results with an improvement in quality of sleep and depressive symptoms [61,62,64]. A systematic review, conducted on 16 articles, concluded that optimal dosage for melatonin supplementation in older adults is the lowest possible dose because it is closest to physiological circadian rhythm of melatonin [68].…”

Section: Role On Quality Of Lifementioning

confidence: 99%

Quality of life for older patients with cancer: a review of the evidence supporting melatonin use

et al. 2020

View full text Add to dashboard Cite

Purpose The proportion of older populations living with cancer is on the increase. Maintaining or improving their quality of life (QoL) has become an important goal in the treatment of cancer and has become an endpoint in clinical trials. Melatonin regulates a wide variety of physiological functions and is involved in the initiation of sleep and the improvement of QoL. With age, the secretion of melatonin decreases and could lead to a deterioration in QoL. Methods Literature searches were conducted using the PubMed database. The search terms and derivatives of "metastatic cancer", "older patients", "quality of life" and "melatonin" were used. Titles and abstracts were screened to identify whether studies were relevant for full-text screening. Results There is major concern about the symptoms older cancer patients encounter during treatment because they can impact their QoL. Melatonin supplementation presents several benefits for older patients: improvement in survival, decrease in symptoms induced by cancer and cancer treatment, and also improvements in quality of life. Conclusion It therefore seems appropriate to study the impact of melatonin supplementation during cytotoxic therapy on QoL among elderly patients with metastatic cancer. The use of melatonin as a therapeutic strategy seems particularly suitable for elderly patients, a population known to secrete significantly less melatonin. However, to date, no studies have been conducted in this population.

show abstract

“…Melatonin as a methoxyindole synthesized and secreted principally by the pineal gland at night under normal light/dark conditions is also an effective drug for the treatment of circadian sleep-wakefulness disorder (5). The application of melatonin before and after surgery can improve sleep quality, and it can also produce a sedative effect in the early postoperative period without obvious side effects (90,91). In addition, melatonin may be considered an effective alternative for benzodiazepines in the management of postoperative sleep disturbances (92).…”

Section: Drug Therapymentioning

confidence: 99%

Sleep Disturbances After General Anesthesia: Current Perspectives

2020

View full text Add to dashboard Cite

The purpose of this article is to review (1) sleep mechanism under general anesthesia, harmful effects of postoperative sleep disturbances; (2) risk factors associated with postoperative sleep disturbances; (3) measures to prevent and improve postoperative sleep disturbances. General anesthesia changes the postoperative sleep structure especially in elderly patients after major surgery and results in a high incidence rate of sleep disturbances. Sleep disturbances produce harmful effects on postoperative patients and lead to a higher risk of delirium, more cardiovascular events, and poorer recovery. Some researchers do propose non-pharmacological treatments such as attention to environmental and psychological factors, application of electroacupuncture (EA) technology and pharmacological treatments are helpful, but larger high-quality clinical trials with longer following-up are needed to further investigate the efficacy and safety.

show abstract

Effect of Melatonin on Sleep in the Perioperative Period after Breast Cancer Surgery: A Randomized, Double-Blind, Placebo-Controlled Trial

Abstract: Melatonin significantly changed sleep efficiency and wake after sleep onset after surgery, but had no effects on other objective sleep outcomes or on subjective sleep quality (VAS and KSS).

Cited by 42 publications

References 42 publications

Perioperative Pharmacological Sleep‐Promotion and Pain Control: A Systematic Review

Perioperative Pharmacological Sleep‐Promotion and Pain Control: A Systematic Review

Quality of life for older patients with cancer: a review of the evidence supporting melatonin use

Sleep Disturbances After General Anesthesia: Current Perspectives

Contact Info

Product

Resources

About