Traumatic Brain Injury Blog

Use of Melatonin for Treatment of TBI and Sleep Disturbance Following TBI

There’s promising research on the use of melatonin for acute treatment of traumatic brain injury (TBI) and for treatment of sleep disturbance following TBI coming from two recent peer-reviewed papers. One, published in the Journal of Neurotrauma, reviews the literature and performs meta-analyses of the data in studies examining the use of melatonin shortly after injury.

The other, published in the journal BMC Med, reports on a randomized controlled trial examining the efficacy of melatonin in treating sleep disturbance following TBI.

Melatonin is an important hormone made by the pineal gland that helps control a person’s sleep and wake cycles.

Both studies report positive results. As explained in the first study, past studies have demonstrated that melatonin is a “potent anti-inflammatory agent” offering “therapeutic potential for many of the common post-TBI symptoms such as sleep disturbance, pain, mood disturbance and increased anxiety.” It also has few side effects. The data analyzed in the first study showed that melatonin given shortly after injury “significantly improved neurobehavioral outcome in neurological, cognitive, and motor domains, as well as in histo-pathological domains (contusion size and cerebral edema [swelling])” The authors do note that although the research is promising “there are insufficient clinical data to support routine use following TBI.” Further research is needed.

The second study examined the use of melatonin clinically to treat sleep disturbance following TBI. As we have reported in prior posts, sleep disturbance can make symptoms worse and slow recovery from TBI. The researchers in the BMC Med study found that the TBI population had reduced evening and overnight melatonin production compared to age and sex matched controls. They also had less sleep efficiency, meaning that they spent more time in non-REM sleep.

The patients who received melatonin supplements reported improved sleep quality and demonstrated increased sleep efficiency. Melatonin also reduced self-reported anxiety symptomatology and fatigue, and increased vitality and mental functioning.

Melatonin is only one of several interventions with promise in addressing sleep issues following TBI. Improving sleep “hygiene” , cognitive behavioral therapy and light therapy have also shown promise. As prior posts have emphasized, sleep disturbance often plays an influential role in prolonging symptoms following TBI and should therefore be addressed early in the clinical setting.