Insomnia correction with synthetic melatonin in patients with rheumatoid arthritis

One of the features of rheumatoid arthritis, as a multiple-factor disease, is the presence of somnological disorders. The aim of the paper is to study the efficacy of synthetic melatonin in insomnia correction and melatonin effect on clinical parameters and quality of life in patients with rheumatoid arthritis. Materials and Methods. The study involved 89 patients, aged 18-45 years old with verified rheumatoid arthritis. The authors used a questionnaire technique to identify subjective sleep quality, the Insomnia Severity Index; Ritchie index, Visual analog scale; TSQM1.4; MOS SF-36. Results. The use of synthetic melatonin for insomnia correction in patients with rheumatoid arthritis improves the basic sleep characteristics. The most pronounced changes were observed in the following parameters "quality of sleep", “duration of sleep" and "frequency of nocturnal awakenings"; positive dynamics of the Ritchie index: reduction of morning stiffness, severity of articular and algetic index. High values of treatment persistence can be considered as significant results of the study. In the course of treatment, there was a significant improvement in the indicators of psycho-emotional status, vitality and algia impact on daily activities. There was a tendency towards a decrease in the quality of life assessment due to the reversed insomnia 30 days after the end of therapy. Conclusion. The use of synthetic melatonin in patients with rheumatoid arthritis improves the basic sleeping characteristics, indirectly affects the basic clinical manifestations of the underlying disease and improves the quality of life. At the same time, the therapeutic effect is short-term: the results of dynamic monitoring of the quality of life 30 days after the end of therapy indicated a decrease in both mental and physical components, which was caused by the reversed insomnia and, as a consequence, a general deterioration in the somatic and mental state.