HormonesMelatonin

Melatonin is more effective than olanzapine in improving sleep quality in cancer patients with insomnia, with a superior adverse effect profile.

In a prospective, double-blind, randomized trial of 60 advanced cancer patients with insomnia, both oral melatonin (3 mg/day) and oral olanzapine (5 mg/day) significantly improved sleep parameters over four weeks (p < 0.001). Melatonin showed statistically significant superiority over olanzapine in PSQI scores at week four and overall AIS scores across all time points, and had a more favorable adverse effect profile (olanzapine was associated with somnolence, akathisia, and weight gain).

Last updated: Aug 19, 2026•1 RCTs•📖 Read as article →

Evidence Score

Evidence Score44/100
Human RCT★★☆☆☆
Meta-analysis☆☆☆☆☆
Mechanism★★★★★
Safety★★★★☆
Confidencelow

Study Evidence

Study 1. Efficacy of Oral Melatonin Versus Oral Olanzapine in Improving Sleep in Cancer Patients with Insomnia: Prospective Comparative Study.

observational

Pingoliya SK, Garg DK, Abdulla S, Bhaskar A · Journal of pain &amp; palliative care pharmacotherapy (2026)

Participants: N/A
Duration: 4 weeks
Intervention: Oral melatonin 3 mg/day versus oral olanzapine 5 mg/day for four weeks
Outcome: Sleep quality assessed by Pittsburgh Sleep Quality Index (PSQI) and Athens Insomnia Scale (AIS) at baseline, 2 weeks, and 4 weeks
Effect Size: N/A (not reported in abstract)
Population: 60 advanced cancer patients with insomnia

Result:

PubMed: 42536921DOI: 10.1080/15360288.2026.2707225

Mechanism Graph

Melatonin regulates circadian rhythms and sleep-wake cycle via MT1 and MT2 receptors.
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Olanzapine blocks histamine H1, dopamine D2, and serotonin 5-HT2A receptors, causing sedation.
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Melatonin's action is more specific to sleep regulation, potentially leading to better sleep quality with fewer side effects.
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Result: Melatonin improved PSQI and AIS scores more than olanzapine, with fewer adverse effects.

Limitations

  • ⚠Small sample size (n=60) limits generalizability.
  • ⚠No placebo control group, so absolute efficacy cannot be established.
  • ⚠Objective sleep measures (e.g., polysomnography) were not used; relied on subjective questionnaires.
  • ⚠Short duration (4 weeks) may not reflect long-term effects.

Frequently Asked Questions

Is melatonin better than olanzapine for sleep in cancer patients?▼

Yes, in this study, melatonin showed statistically significant superiority over olanzapine in improving PSQI scores at week 4 and overall AIS scores, with a better side effect profile.

What dose of melatonin was used in this study?▼

The dose was 3 mg per day, taken orally for four weeks.

What are the common side effects of olanzapine in this context?▼

Olanzapine was associated with somnolence, akathisia, and weight gain, whereas melatonin had a more favorable adverse effect profile.

How was sleep quality measured in this trial?▼

Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI) and Athens Insomnia Scale (AIS) at baseline, 2 weeks, and 4 weeks.

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References

  1. 1.Pingoliya SK, Garg DK, Abdulla S, Bhaskar A. "Efficacy of Oral Melatonin Versus Oral Olanzapine in Improving Sleep in Cancer Patients with Insomnia: Prospective Comparative Study.." Journal of pain &amp; palliative care pharmacotherapy, 2026. PMID: 42536921 DOI: 10.1080/15360288.2026.2707225
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.