Melatonin may improve sleep quality after arthroscopic rotator cuff repair
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LAS VEGAS — Although melatonin use led to an initial decreased sleep quality after arthroscopic rotator cuff repair, sleep quality improved by 26 weeks postoperatively, according to results presented here.
“This preliminary analysis shows that there may be a role for melatonin to play in the postoperative care after arthroscopic rotator cuff repair,” Anya Hall, BS, said in his presentation at the American Academy of Orthopaedic Surgeons Annual Meeting. “We’ll be interested to see if these findings continue as the study is fully powered.”
Hall and colleagues randomly assigned 53 patients undergoing primary arthroscopic rotator cuff repair to either receive a 6-week supply of 5 mg of melatonin to be taken an hour before bedtime starting on the day of surgery or to a standard sleep hygiene group instructed to aim for at least 6 hours of sleep per night and to avoid caffeine and naps in the evening. Hall noted patients completed the Pittsburgh Sleep Quality Index (PSQI), the American Shoulder and Elbow Surgeons Standardized Shoulder Assessment form, single assessment numerical evaluation (SANE) score and pain medication chart preoperatively and at 2, 6, 12, 16 and 26 weeks postoperatively. Patients in the melatonin group also reported melatonin adherence.
“In the treatment group, about 30% of patients missed more than two doses of melatonin in their treatment period,” Hall said. “The most common adverse effects described were daytime drowsiness or headache.”
Although there were no statistically significant differences between the two groups on a pointwise comparison, Hall noted that on a pairwise comparison, patients in the control group had faster improvement in shoulder function compared with the melatonin group. However, over time, both groups showed significant improvement in shoulder function, according to Hall. Similarly, he added both groups showed improvement in SANE score, but the standard sleep hygiene group had faster improvement vs. the melatonin group.
“However, with the PSQI score, where a lower score represents greater sleep quality, there was no difference in the standard sleep hygiene group,” Hall said. “However, the patients in the melatonin group showed an initial decrease in their sleep quality, but by the end of the study, they had a significant improvement in their sleep quality.”
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Hall A, et al. Paper 240. Presented at: American Academy of Orthopaedic Surgeons Annual Meeting; March 7-11, 2023; Las Vegas.
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