HormonesMelatonin

Melatonin improves sleep quality in chronic non-cancer pain patients without increasing adverse events

Moderate-certainty evidence from a network meta-analysis of 98 RCTs (28,920 participants) showed that melatonin significantly improved subjective sleep quality compared to placebo (SMD = -0.60, 95%CI: -0.98, -0.22). Unlike other pharmacological agents, melatonin was not associated with an increased risk of adverse events (OR = 0.88, 95%CI: 0.19, 3.94).

Last updated: Jul 12, 2026•0 RCTs•1 Meta-analyses•📖 Read as article →

Evidence Score

Evidence Score49/100
Human RCT☆☆☆☆☆
Meta-analysis★★★☆☆
Mechanism★★★★★
Safety★★★★☆
Confidencelow

Study Evidence

Study 1. Comparative effectiveness and safety of pharmacological interventions for sleep outcomes in chronic non-cancer pain: a systematic review and network meta-analysis.

observational

Chang JR, Zhang Y, Zhang Y, Lin LG, Hamoudi H, Li SX, Chan EWY, Runge N, Saueressig T, Singh H, Samartzis D, Heikkala E, Karppinen J, Traeger AC, Wong AY · Sleep medicine reviews (2026)

Participants: N/A
Duration: N/A
Intervention: Melatonin (dose not specified in abstract)
Outcome: Subjective sleep quality (measured by standardized mean difference)
Effect Size: SMD = -0.60 (95%CI: -0.98, -0.22)
Population: Adults with chronic non-cancer pain (mean age 53.2 years, 71.2% female)

Result:

PubMed: 42430948DOI: 10.1016/j.smrv.2026.102340

Mechanism Graph

Melatonin regulates circadian rhythm and sleep-wake cycles
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May modulate pain perception through anti-inflammatory and antioxidant effects
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Reduces sleep onset latency and improves sleep maintenance
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Result: Improved subjective sleep quality without increased adverse events

Limitations

  • ⚠Limited direct comparisons between agents
  • ⚠Heterogeneous chronic pain populations
  • ⚠High proportion of trials at high risk of bias
  • ⚠Predominance of subjective sleep outcomes

Frequently Asked Questions

Is melatonin safe for people with chronic pain?▼

Yes, the study found melatonin was not associated with an increased risk of adverse events (OR = 0.88, 95%CI: 0.19, 3.94), unlike other sleep medications.

How much does melatonin improve sleep quality in chronic pain patients?▼

Melatonin showed a moderate improvement in sleep quality with a standardized mean difference of -0.60 compared to placebo.

What other medications were tested for sleep in chronic pain?▼

Ten agents including amitriptyline, oxycodone, gabapentin, pregabalin, and duloxetine showed improvements but with low-certainty evidence and increased adverse event risks.

Should I take melatonin instead of prescription pain medications for sleep?▼

The study suggests melatonin is a promising safe adjunctive option, but larger condition-specific trials are needed to confirm effects.

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References

  1. 1.Chang JR, Zhang Y, Zhang Y, Lin LG, Hamoudi H, Li SX, Chan EWY, Runge N, Saueressig T, Singh H, Samartzis D, Heikkala E, Karppinen J, Traeger AC, Wong AY. "Comparative effectiveness and safety of pharmacological interventions for sleep outcomes in chronic non-cancer pain: a systematic review and network meta-analysis.." Sleep medicine reviews, 2026. PMID: 42430948 DOI: 10.1016/j.smrv.2026.102340
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.