Sleep quality and sleepiness in adults with multiple myeloma. Is melatonin a potential treatment?

Sleep disturbances significantly impact quality of life in cancer patients, yet remain poorly characterized in multiple myeloma (MM). This observational study aimed to characterize sleep profiles in MM patients and evaluate the therapeutic potential of exogenous melatonin. We assessed 46 MM patients and 64 age-matched controls using the Pittsburgh Sleep Quality Index (PSQI) and Epworth Sleepiness Scale (ESS). Data revealed significantly worse sleep quality in MM patients compared to controls (global PSQI: U = 1126; p = 0.034), with 75% of patients exhibiting poor sleep quality or sleep disorders. Component analysis showed specific impairments in sleep latency (p = 0.011), sleep duration (p = 0.0013), and medication use (p = 0.0056). Paradoxically, while MM itself significantly impaired sleep quality, exogenous melatonin supplementation did not ameliorate this effect and was associated with worsened PSQI scores in controls. We observed a dissociation between sleep quality and daytime sleepiness, as ESS scores showed no significant group differences (p = 0.58) or treatment effects. These findings provide the first systematic characterization of sleep disturbances in MM, establishing poor sleep quality as a prevalent disease feature. While melatonin influenced specific sleep parameters, its limited efficacy in improving global sleep quality underscores the need for further investigation into standardized chronotherapy approaches for managing sleep-wake disturbances in this population.