Could Melatonin Be an Alternative to Benzodiazepine for Chronic Obstructive Pulmonary Disease With Insomnia?

Abstract

Chronic obstructive pulmonary disease (COPD) is common, with a 10% global prevalence and a significant health problem, and is one of the main causes of morbidity. Patients with COPD experience various types of sleep problems with insomnia as the most common sleep disorder. The presence of sleep disorders further deteriorates their quality of life. Benzodiazepines (BZDs) are commonly prescribed drugs for insomnia. Several meta-analyses have shown that BZDs effectively reduce insomnia; however, severe side effects including rebound insomnia, next-day hangover, anterograde amnesia, and cognitive impairment occur. Since COPD patients often complain of symptoms such as shortness of breath, safe treatment for sleep disorders is needed. Melatonin supplements have a safe profile and are well-tolerated. Therefore, melatonin can be safely prescribed to treat insomnia in patients with COPD. In addition, due to the anti-inflammatory activity of melatonin, it can be an alternative to BZDs for improving insomnia symptoms without exacerbating respiratory symptoms. It would be helpful to more actively screen and detect sleep disorders in adults with COPD, and to provide safe melatonin treatment for improving their quality of life.