In patients with advanced primary open-angle glaucoma, oral melatonin did not improve sleep quality or objective sleep measures compared with placebo, despite both groups reporting modest improvements over time, suggesting a temporal or placebo-related effect rather than a true treatment benefit, according to a study.
The study enrolled 64 patients who received 5 mg of melatonin or placebo daily for 30 days, followed by a 1-week washout period before crossing over to the alternate treatment. Sleep quality was assessed subjectively using the Pittsburgh Sleep Quality Index and the Epworth Sleepiness Scale, while objective sleep measures, including total sleep time, wake after sleep onset, number of awakenings, and sleep efficiency, were recorded using actigraphy. Vision-related quality of life was evaluated with the National Eye Institute Visual Function Questionnaire–25, alongside standardized ophthalmic testing.
No significant differences were observed between melatonin and placebo for any primary or secondary sleep outcomes or for vision-related quality of life. Actigraphy measures, including sleep efficiency, total sleep time, wake after sleep onset, and number of awakenings, were also unaffected by melatonin supplementation.
Despite the lack of treatment-related differences, both groups demonstrated improvements over time. Pittsburgh Sleep Quality Index scores decreased and National Eye Institute Visual Function Questionnaire–25 scores increased during the study period, suggesting a temporal effect. Poor sleep quality and reduced sleep efficiency were associated with worse objective sleep parameters and lower vision-related quality of life. No carryover or sequence effects were detected.
Reference
Nogueira PF, Vallim JRS, Barboza MNC, et al. Effects of Melatonin Supplementation on Sleep Quality in Patients with Advanced Glaucoma: A Randomized, Double-Blind, Placebo-Controlled Crossover Trial. Ophthalmol Glaucoma. 2025;S2589-4196(25)00250-9. doi: 10.1016/j.ogla.2025.12.003. Epub ahead of print. PMID: 41386535.
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