Badran Ahmed Samy, Khelifa Hamza, Gbreel Mohamed Ibrahim
Faculty of Medicine, Ain Shams University, Cairo Governate, Cairo, 1181, Egypt.
Faculty of Medicine, University of Oran 1 Ahmed Ben Bella, Oran, Algeria.
Neurol Sci. 2025 May 19. doi: 10.1007/s10072-025-08221-8.
Parkinson's disease (PD), a progressive neurodegenerative disorder, often involves sleep disturbances, affecting 88-98% of patients. Melatonin, a sleep-regulating neurohormone, shows the potential to improve sleep quality and non-motor symptoms in PD.
To evaluate melatonin's efficacy and safety in PD patients with sleep disorders.
We systematically searched PubMed, Scopus, Web of Science, and Cochrane till January 2025. The risk of bias in the included studies was evaluated using the Cochrane risk-of-bias tool. Dichotomous outcomes were expressed as risk ratios (RRs) with 95% confidence intervals (CIs), while continuous outcomes were reported as mean differences (MDs) with 95% CIs.
We retrieved 2537 records. Five double-blinded RCTs were finally included. The meta-analysis revealed a significant improvement in sleep quality, as measured by the Pittsburgh Sleep Quality Index (PSQI), in the melatonin group compared to placebo (MD= -1.88, 95% CI: [-3.07, -0.68], P = 0.002). However, no significant differences were observed for the Epworth Sleepiness Scale (MD= -1.04 CI: [-2.81, 0.73], P = 0.25), total sleep time (MD = 14.85 min CI: [-5.45, 35.16], P = 0.15), sleep efficiency, sleep latency, REM sleep latency, frequency of arousals, or REM Sleep Behavior Disorder Screening Questionnaire (RBDSQ; MD = 0.74, P = 0.50). For Parkinson's disease-related outcomes, melatonin significantly improved Non-Motor Symptom Scale (NMSS) scores but showed no significant effects on UPDRS Part III scores or Parkinson's Disease Quality of Life.
Melatonin improves subjective sleep quality and non-motor symptoms in PD patients with a favorable safety profile, but effects on objective measures and motor symptoms remain inconclusive.
This meta-analysis was registered on PROSPERO.
CRD42024619496.
帕金森病（PD）是一种进行性神经退行性疾病，常伴有睡眠障碍，影响88%-98%的患者。褪黑素是一种调节睡眠的神经激素，显示出改善PD患者睡眠质量和非运动症状的潜力。
评估褪黑素对PD睡眠障碍患者的疗效和安全性。
我们系统检索了截至2025年1月的PubMed、Scopus、Web of Science和Cochrane数据库。使用Cochrane偏倚风险工具评估纳入研究的偏倚风险。二分法结局以风险比（RRs）及其95%置信区间（CIs）表示，连续结局以平均差（MDs）及其95% CIs报告。
我们检索到2537条记录。最终纳入5项双盲随机对照试验。荟萃分析显示，与安慰剂相比，褪黑素组的匹兹堡睡眠质量指数（PSQI）所衡量的睡眠质量有显著改善（MD = -1.88，95% CI：[-3.07，-0.68]，P = 0.002）。然而，在爱泼华嗜睡量表（MD = -1.04，CI：[-2.81，0.73]，P = 0.25）、总睡眠时间（MD = 14.85分钟，CI：[-5.45，35.16]，P = 0.15）、睡眠效率、睡眠潜伏期、快速眼动睡眠潜伏期、觉醒频率或快速眼动睡眠行为障碍筛查问卷（RBDSQ；MD = 0.74，P = 0.50）方面未观察到显著差异。对于帕金森病相关结局，褪黑素显著改善了非运动症状量表（NMSS）评分，但对统一帕金森病评定量表第三部分（UPDRS Part III）评分或帕金森病生活质量没有显著影响。
褪黑素可改善PD患者的主观睡眠质量和非运动症状，安全性良好，但对客观指标和运动症状的影响仍不明确。
本荟萃分析已在PROSPERO注册。
CRD42024619496。
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