Insomnia and poor quality of sleep are common among people living with chronic kidney disease (CKD). Insufficient and poor quality sleep can lead to chronic fatigue, reduced quality of life, faster CKD progression, and higher mortality rates. A 2023 study published in the medical journal Cells explored the potential benefits of melatonin for relieving sleeplessness in CKD patients. Here’s what they found.*

What is melatonin?

Melatonin is a hormone that helps regulate a person’s circadian rhythm, or sleep-wake cycle. This cycle affects multiple biological processes, both mental and physical, as well as our behavior. Ongoing disruption of the sleep-wake cycle can lead to other hormonal imbalances, as well as nervous, metabolic, and cardiovascular disorders. 

The production of melatonin is dependent on the natural cycle of light and darkness, and mainly occurs at night. The amount of sleep you get directly impacts how much melatonin your body secretes, and for how long, each night.  

Melatonin is primarily produced by the pineal (pin-ee-ul) gland in the brain, but is also generated by the:

• Photoreceptors in your retina
• Gastrointestinal tract
• Bone marrow
• Thyroid and thymus
• Pancreas and spleen
• Reproductive tract
• Endothelial cells (that line blood vessels)
• Liver and kidneys

Enzymes involved in the production of melatonin are also produced in your skin. Melatonin production declines as we age.

How melatonin supports overall health

Melatonin plays important roles in many body systems, including the:

Nervous system. Changes in melatonin concentration levels can result in mood disturbances, cognitive dysfunction, and problems with learning and memory problems. Melatonin has a neurologically protective effect, and has been used to treat Alzheimer’s, Parkinson’s, Huntington’s, ALS, stroke, and various forms of brain trauma.

Immune system. Melatonin can strengthen the immune system. It has direct anti-viral and anti-bacterial effects, even on severe infections. The use of melatonin has been proven to reduce mortality due to viral and bacterial inflammation.Studies suggest that it may be beneficial as a supportive therapy for COVID-19 after initial treatment. 

Gastrointestinal system. Melatonin reduces hydrochloric acid production, boosts regeneration of the epithelium (which lines body cavities), and is protective against irritants in the stomach and esophagus. It has been used to treat ulcers and gastroesophageal reflux disease, and to help prevent irritable bowel syndrome, ulcerative colitis, and colorectal cancer.

Cardiovascular system. Melatonin helps regulate blood pressure and body mass, and has antioxidant effects by scavenging harmful free radicals in mitochondria, the energy source in cells. It is protective against ischemic heart disease and can help prevent damage from insufficient bloodflow. 

Respiratory system. Melatonin’s anti-inflammatory properties help protect the lungs by  eliminating harmful reactants, detoxifying nitric oxide, and inhibiting the spread of cancer cells. It also helps reduce pulmonary fibrosis (scarring of the lungs). 

How melatonin can help people with CKD

People living with CKD commonly experience difficulty falling asleep, staying asleep, and getting good quality sleep. This is especially true for those who are on dialysis or who undergo kidney transplantation. Approximately 80% of patients with kidney failure report having sleep disorders. 

Research indicates that melatonin can:

• Help people fall asleep faster,
• Regulate the duration of time awake, and
• Improve cognitive function, concentration, and reflexes. 

Disrupted circadian rhythms are linked to oxidative damage, greater risk of sudden cardiovascular events like heart attack and stroke, and cardiovascular disease, which is one of the primary causes of CKD, as well as one of the leading causes of CKD progression to kidney failure and death. Melatonin can reduce oxidative damage and improve cardiac function.

Diabetes is another major cause and complication of CKD. Melatonin helps combat complications from diabetes by:

• Supporting the clearance of cholesterol, 
• Protecting tissues from oxidized lipoproteins,
• Reducing glucose intolerance, and 
• Lowering insulin resistance. 

Multiple studies show that melatonin is effective in treating acute kidney disease due to:

• Medications,
• Radiation, and
• Surgical procedures.

It has also been shown to improve kidney function following transplantation.

An increasing number of studies provide mounting evidence that melatonin can improve the quality of life, and prolong the lives, of people living with CKD.

*Markowska, M., Niemczyk, S., and Romejko, K. (2023, March 8). Melatonin Treatment in Kidney Diseases. Cells, 12(6), 838. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10047594/#:~

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