Role of Melatonin in the Management of Sleep Disorders in Schizophrenia: A Literature Review

Introduction and Objective: Sleep and circadian rhythm disturbances are highly prevalent in Schizophrenia and significantly impact symptom severity, disease progression, and treatment outcomes. Schizophrenia, a chronic and disabling mental illness affecting approximately 1% of the global population, is particularly associated with pronounced sleep abnormalities. Over 80% of patients with schizophrenia experience reduced sleep efficiency and delayed sleep onset. These disturbances are closely linked to worsening psychotic symptoms, cognitive dysfunction, and diminished quality of life. This review aims to explore the role of melatonin in these disruptions and its potential as an adjunctive treatment in Schizophrenia. Materials and methods: Articles in PubMed, GoogleScholar, ScienceDirect databases were retrieved by the authors. The authors searched with keywords: melatonin, schizophrenia, sleep disorder, circadian rhythms, psychiatric disease. Articles between 2000 and 2024 were included. Results: Randomized controlled trials show that prolonged-release melatonin (2–10 mg, 1–2 hours before bedtime) improves sleep latency, efficiency, and duration in schizophrenia. Melatonin, immediate-release, has variable findings; low doses (<1 mg) are used to treat circadian disorders, while higher doses (3–12 mg) are used to treat insomnia. Melatonin will also improve benzodiazepine withdrawal insomnia and help habituate to sleep in a novel environment. It is tolerable with mild but occasional side effects, but larger, high-quality trials are needed. Conclusions: Melatonin is of great promise as an adjunct to sleep and circadian disturbance treatment in schizophrenia and related psychiatric illnesses, but more extensive research must be conducted to confirm its long-term safety and clinical efficacy.