Abstract

Objective: This study aimed to assess whether the use of melatonin as an initial insomnia treatment can enhance inflammatory status and quality of life (QoL). We also explored a potential correlation between these improvements and sleep pattern ameliorations and whether baseline status correlated to differences in sleep quality, inflammatory status, and QoL. Methods: We enrolled 67 subjects from 6 different hospitals who met Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) insomnia criteria. The patients took 2 mg per day of prolonged-release melatonin (PRM) for 8 weeks. We administered the Pittsburgh Sleep Quality Index (PSQI) to assess sleep quality and the WHO-5 Well-Being Index to assess QoL at baseline, week 4, and week 8. We measured tumor necrosis factor-alpha (TNF-α) levels to determine inflammatory status at baseline and week 8.Results: The mean global PSQI score declined significantly from 13.97 to 10.39 (p<0.001) after 8 weeks of PRM treatment. The mean WHO-5 Well-Being Index score improved significantly from 7.30 to 11.0 (p<0.001) over the study period. The mean TNF-α nonsignificantly declined from 0.62 to 0.60 (p=0.28). The PSQI improvement over 8 weeks was correlated to the baseline PSQI score (r=0.40, p=0.001). The decrease in TNF-α over 8 weeks was correlated to the baseline TNF-α level (r=0.43, p<0.001).Conclusion: This study reported measurable improvement in sleep quality and QoL after 8 weeks of PRM. Although the decrease in TNF-α level over 8 weeks was not significant, it showed correlation to the baseline TNF-α level. PRM can prevent excessive inflammation and may be beneficial in chronic inflammation involving TNF-α.

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