HormonesMelatonin

Melatonin and its receptor agonists may help regulate circadian rhythms and improve subjective sleep quality in cardiac surgery patients, but effects on delirium, length of stay, and objective sleep architecture are inconsistent.

The review indicates that melatonin and its receptor agonists can improve subjective sleep quality and help regulate circadian rhythms in patients undergoing cardiac surgery. However, their effects on key clinical outcomes such as postoperative delirium, length of hospital stay, and objective measures of sleep architecture remain inconsistent across studies.

Last updated: Aug 3, 2026•0 RCTs•📖 Read as article →

Evidence Score

Evidence Score32/100
Human RCT☆☆☆☆☆
Meta-analysis☆☆☆☆☆
Mechanism★★★★★
Safety★★★★☆
Confidencelow

Study Evidence

Study 1. Perioperative sleep management in cardiac surgery: an evidence-oriented narrative review of pharmacological, behavioral, and respiratory support strategies.

observational

Kong B, Yang Y, Song M, Yan M, Meng Y · Frontiers in cardiovascular medicine (2026)

Participants: N/A
Duration: N/A
Intervention: Melatonin and its receptor agonists
Outcome: Subjective sleep quality, circadian rhythm regulation, postoperative delirium, length of hospital stay, objective sleep architecture
Effect Size: N/A
Population: Patients undergoing cardiac surgery

Result: The review indicates that melatonin and its receptor agonists can improve subjective sleep quality and help regulate circadian rhythms in patients undergoing cardiac surgery. However, their effects on key clinical outcomes such as postoperative delirium, length of hospital stay, and objective measures of sleep architecture remain inconsistent across studies.

PubMed: 42495077DOI: 10.3389/fcvm.2026.1853937

Mechanism Graph

Melatonin binds to MT1 and MT2 receptors in the suprachiasmatic nucleus
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This modulates circadian phase shifting and sleep-wake cycle regulation
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Receptor agonists enhance these effects with longer half-life or receptor selectivity
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Result: Improved subjective sleep quality and circadian rhythm alignment

Limitations

  • ⚠Inconsistent findings across studies regarding objective sleep architecture and clinical outcomes
  • ⚠Limited evidence specific to cardiac surgery patients, with much data from other populations

Frequently Asked Questions

Does melatonin reduce delirium after cardiac surgery?▼

The evidence is inconsistent; some studies suggest a potential benefit, but the review notes that effects on delirium remain unclear.

How does melatonin compare to dexmedetomidine for sleep in cardiac surgery?▼

Melatonin primarily targets circadian regulation and subjective sleep quality, while dexmedetomidine has sedative properties resembling non-REM sleep but with hemodynamic risks. Both have inconsistent evidence for key outcomes.

Is melatonin safe for perioperative use in cardiac surgery patients?▼

The review does not report major safety concerns for melatonin, but its efficacy for objective sleep outcomes and clinical endpoints is not consistently established.

What dose of melatonin is recommended for cardiac surgery patients?▼

The abstract does not specify a recommended dose; dosing varies across studies and is not standardized in this review.

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References

  1. 1.Kong B, Yang Y, Song M, Yan M, Meng Y. "Perioperative sleep management in cardiac surgery: an evidence-oriented narrative review of pharmacological, behavioral, and respiratory support strategies.." Frontiers in cardiovascular medicine, 2026. PMID: 42495077 DOI: 10.3389/fcvm.2026.1853937
Disclaimer: This content is for educational purposes only and is not medical advice. Evidence scores reflect the quality and quantity of available research, not clinical recommendations. Always consult a healthcare professional before starting any supplement or intervention.