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Myeloma. Melatonin and Heart Risk?
What do myeloma, melatonin, and heart risk all have in common? Not much, according to the research linked below. Or the link between the three is tenuous at best.
This post is directed at MM survivors who have insomnia. Or problems with sleep in general. Which is most all MM survivors, I know.
Full transparency- I am a MM survivor. I have CIC and chronic Afib. And I take melatonin. But low dose and only once a week or so. I take many different nutritional supplements, but all supplementation is at or below the amounts the label instructs.
The key issue, as I see it, is that many forms of chemotherapy can disrupt our biological clock. We all know what dexamethasone can do to our sleep!
I posted the video below because it stresses that we need to know more than this study before we make any decisions.
What to know about melatonin and heart failure
Scroll down the page, post a question or comment about MM, sleep or any other issues you are wondering about. I will reply ASAP.
Hang in there,
David Emerson
- MM Survivor
- MM Cancer Coach
- Director PeopleBeatingCancer
Common OTC Sleep Aid Linked to Heart Failure Risk
Prolonged use of melatonin for the treatment of insomnia was associated with an increased risk for heart failure, hospitalization, and/or all-cause mortality, an observational study showed.
Individuals with insomnia taking melatonin for a year or more had an 89% higher chance of incident heart failure over 5 years than those who didn’t take it. They were also 3.5 times more likely to be hospitalized for the condition, the preliminary findings, which are not yet peer reviewed, suggested.
“Long-term nightly use may not be as risk-free as we assumed,” lead author Ekenedilichukwu Nnadi, MD, chief resident in internal medicine at SUNY Downstate/Kings County Primary Care, Brooklyn, New York, told Medscape Medical News.
While the study does not show causation and short-term use doesn’t appear to raise cardiac risks, “if you’re using it indefinitely, especially if you have heart disease or risk factors, it’s something worth discussing with your physician,” Nnadi said…
Challenging Previous Findings
Previous research suggested melatonin may be beneficial for cardiometabolic health, in part due to its antioxidant properties. Other studies have indicated taking melatonin supplements before sleep can lower blood pressure.
In the US, melatonin is available over the counter and marketed as a low-cost sleep aid. However, the investigators highlighted that robust data on its long-term cardiovascular effects were lacking.
The investigators reviewed data from the TriNetX Global Research Network database of 130,828 adults (average age, 55.7 years; 61% women) with a diagnosis of insomnia. Half of participants were prescribed melatonin at least once and reported taking it for at least 12 months.
Patients in the control group were not prescribed the sleep aid and were matched to the melatonin group on 40 different factors, including age, sex, race or ethnicity, heart and nervous system diseases, medications for heart and nervous system diseases, blood pressure, and BMI…
The primary endpoint was incident heart failure, based on the International Classification of Diseases, 10th Revision, code I50. The secondary endpoints were hospitalization for heart failure and mortality.
Higher Risk for Heart Failure
During a follow-up period of 5 years, incident heart failure occurred in 4.6% of melatonin users compared with 2.7% of control individuals (hazard ratio [HR], 1.89; 95% CI, 1.78-2.00)…
No Clear Mechanism
Although chronic insomnia itself can cause heart failure, Nnadi said that wasn’t an issue in this cohort.
“In our study, everyone had insomnia. So, the baseline risk was really the same. What really stood out was that melatonin just had a higher risk,” Nnadi said.
Asked to comment, Logan Schneider, MD, adjunct clinical associate professor of sleep medicine at Stanford Sleep Medicine Center in Redwood City, California, and member of the American Academy of Neurology, agreed.
“It’s likely, based on the sample sizes, that poor sleep is equally represented in both groups, such that it probably doesn’t represent a confounder,” Schneider, who wasn’t involved in the study, told Medscape Medical News.
The US doesn’t require a prescription for melatonin, so it’s possible that those in the control group may have taken it. Other limitations included a lack of information on insomnia severity and psychiatric disorders.
The lack of peer review and the observational or claims-based analysis were also limitations, Schneider said.
He noted the lack of a clear pathophysiologic mechanism to explain the findings and suggested the authors explore potential mechanisms that link melatonin to increased heart failure risk.
A recent systemic review bolstered evidence of melatonin’s positive effects for patients with heart failure, suggesting it as a new treatment for these cardiac patients, even in palliative care…
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