Melatonin at night may help with morning balance, strength in MS

Taking melatonin before bedtime may help balance and muscle strength in people living with multiple sclerosis (MS), according to a study from Tunisia.

Those benefits are in addition to making for more restful sleep. While the findings come from a small number of patients, they suggest melatonin supplements may help MS-related movement problems.

The study, “Effects of a nighttime melatonin ingestion on dynamic postural balance and muscle strength the following morning in people living with multiple sclerosis: A preliminary study,” was published in Clinical Neurology and Neurosurgery.

Many people with MS don’t produce enough melatonin and may have trouble falling asleep or sleeping through the night. Poor sleep may lead to daytime drowsiness and worsen MS symptoms, including problems with balance and muscle weakness.

Melatonin occurs naturally in the body, with levels rising at night in response to darkness and then falling during the day. This helps the body know when it’s time to go to sleep and wake up. Taking a melatonin supplement can help by adding to the body’s natural supply.

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The researchers tested how quick-release tablets of 6 mg of melatonin might improve balance and muscle strength versus a placebo in adults with relapsing-remitting MS, in which periods of new or worsening symptoms are followed by recovery.

“Dynamic postural stability and muscle strength play an essential role in ensuring a safe and independent functioning during daily activities, as well as having a better quality of life,” the researchers wrote.

Seven of the 14 patients who completed the study were given melatonin, and another seven took the placebo, about 30 minutes before bedtime. Their maximum Expanded Disability Status Scale score, a standardized measure of functional disability, was 4, denoting significant disability but no walking impairments.

The researchers measured the balance, muscle strength, hand dexterity, pain levels, sleep quality, and fatigue of the participants the next morning. The choice of melatonin dose, 6 mg, was based on positive safety and efficacy results in previous studies, with improvements in posture and balance being reported.

Patients who took melatonin had better balance and gained muscle strength. Melatonin also reduced the sway of their center of pressure, which is important for balance, with improvement seen in both side-to-side and front-to-back movements.

Those who took melatonin also performed better on a test of lower-extremity muscle strength that measures the time taken to stand five times from a chair with arms folded. Hand dexterity, however, was not improved.

Taking melatonin also relieved pain. Nociceptive (damage-related) pain was reduced by 5.7% compared with the placebo. For neuropathic (nerve-related) pain, the reduction was even larger, by 27.3%.

Those who took melatonin said they felt less fatigued, by 40.2%, and had slept better, by 30.2%, than those on the placebo.

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The study suggests taking melatonin at night can be safe and offer benefits to people with relapsing-remitting MS, as it helps improve balance and muscle strength while easing pain and fatigue.

“This preliminary study showed that acute melatonin ingestion was safe and efficient for improving dynamic postural stability and lower-extremity muscle strength, probably through its analgesic [pain-relieving] and anti-fatigue effects,” the researchers wrote.

Since the study was small, more research is needed to confirm the findings and understand the long-term effects of melatonin, the researchers wrote. Future studies should also “use more objective measures for the assessment of fatigue, pain, and sleep quality,” they added.