Sleep disorders are common in kidney disease patients on dialysis due to a disturbance in their biological clocks. Marije Russcher, PharmD, Birgit Koch, PharmD, PhD, (Meander Medical Center, in Amersfoort, the Netherlands) and colleagues previously found that giving dialysis patients melatonin, a hormone that helps regulate sleep and wake cycles, can improve sleep over a short period of time.

Now, these researchers have investigated whether the benefits of melatonin on sleep persist over the long term, and if long-term use of melatonin could improve patients' quality of life. 70 dialysis patients received melatonin or a placebo for 1 year. At 3 months, the previously shown beneficial effect of the short-term use of melatonin on sleep onset was confirmed.

The investigators also noted improvement of sleep efficiency and sleep time. In contrast, at 12 months none of the measured sleep parameters differed significantly from placebo. Regarding quality of life, melatonin had a positive effect on social functioning and a trend in improvement of mentality. "We confirmed the short term beneficial effects of melatonin on sleep; however, we found no indication that these beneficial effects persist in long-term usage of melatonin," said Ms. Russcher. "Further research should focus on optimizing melatonin dosage and time of dosing, specifically in kidney patients."

Study co-authors include Ernst Hagen, MD, PhD, Elsbeth Nagtegaal, PharmD, PhD, Monique van der Westerlaken, PharmD (Meander Medical Center, in Amersfoort, the Netherlands); Carlo Gaillard, MD, PhD (Meander Medical Center, in Amersfoort and the VU Medical Center, in Amsterdam, the Netherlands); Frans van Ittersum, MD, PhD and Pieter M. Ter Wee, MD, PhD (the VU Medical Center, in Amsterdam, the Netherlands), Wim van Dorp, MD, PhD (Kennemer Hospital, in Haarlem, the Netherlands), Bas Gabreëls, MD, PhD (Rijnland Hospital, in Leiderdorp, the Netherlands)

Dr. Ter Wee receives research support from Abbott, Baxter, Gambro, Fresenius, and Roche and honoraria from Amgen, Roche, Genzyme, and Fresenius.

The study abstract, "The Long-Term Effects of Melatonin on Sleep and Quality of Life in Hemodialysis Patients," [SA-PO2333] was presented as a poster on November 20, 2010 at the Colorado Convention Center in Denver, CO.