Melatonin may not improve sleep disturbance after TKR
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Key takeaways:
- Melatonin did not improve subjective sleep scores in patients who underwent total knee replacement compared with placebo.
- Melatonin did not improve patient-reported outcome measures compared with placebo.
GRAPEVINE, Texas — Melatonin may not improve postoperative sleep disturbance following total knee replacement, according to results presented at the American Association of Hip and Knee Surgeons Annual Meeting.
“Melatonin did not improve subjective sleep quality or patient-reported outcomes at 6 weeks or 90 days following knee replacement,” Drake G. Lebrun, MD, said during his presentation. “We did find that patients who slept poorly tended to fare worse in other realms, as reflected by their worse patient-reported outcomes, and melatonin did not modify any of those associations.”
Lebrun and colleagues randomly assigned 172 patients who underwent TKR to receive either 5 mg melatonin (n = 86) or 250 mg vitamin C placebo (n = 86) daily for 6 weeks. Outcomes measured included Pittsburgh Sleep Quality Index (PSQI), patient-reported outcome measures, adverse events, medication compliance and hospital readmission rates 6 weeks and 90 days after TKR.
Lebrun said melatonin did not improve subjective sleep scores at 6 weeks or 90 days compared with the placebo group.
“We did find that sleep scores worsened overall at 6 weeks in both groups before returning to normal at 90 days,” Lebrun said.
He said nearly 70% of patients had some form of sleep deficit 6 weeks postoperatively, and although mean sleep scores improved at 90 days, nearly 50% of patients still had sleep deficits at that timepoint. Melatonin did not improve patient-reported outcome measures compared with the placebo group, according to Lebrun.
In addition, Lebrun said poor sleep had an association with decreased patient-reported outcome measures. There were no differences in medication compliance, adverse events or 90-day hospital readmissions between the two groups, according to Lebrun.
“Our study does not support the routine use of melatonin as a simple fix to an otherwise complex and quite common problem in postoperative sleep disturbance,” Lebrun said.
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Lebrun DG, et al. Paper 33. Presented at: American Association of Hip and Knee Surgeons Annual Meeting; Nov. 2-5, 2023; Grapevine, Texas.
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