Disturbed Sleep Behaviors and Melatonin in Sleep Dysfunction and Treatment of Cystic Fibrosis

Cystic fibrosis (CF) patients experience clinically significant sleep dysfunction, resulting in impaired cognitive function, decreased activation, decreased affect, and lowered quality of life. The exact mechanism driving this dysfunction still is unknown, but it appears linked to disease severity, nocturnal hypoxemia, and frequent instances of sleep disturbance. Melatonin is a neurohormone that is secreted in the pineal gland of mammals and is available without a prescription as a supplement in some countries, including the United States. Melatonin is a key molecule in regulating the natural sleep-wake cycle, and administration of exogenous melatonin is known to lower body temperature and awareness as well as induce sleep. Melatonin is useful for increasing subjective sleep quality in CF patients. Melatonin likely would reverse detrimental effects on sleep loss brought on by β-antagonists and likely would help to maintain a healthy sleep-wake cycle. Melatonin would not address the underlying causes of sleep dysfunction and disturbances would remain an issue. Melatonin potentially could worsen episodes of nocturnal hypoxemia by increasing rapid eye movement sleep and encouraging hypoventilation. Melatonin possesses antioxidant and antimicrobial properties, which could improve lung health and sleep by proxy.