The effect of preoperative melatonin patches on sleep quality in patients undergoing urological surgery

Toprak, Çağla; Akinci, Naile; Akok, Selin Ayten

doi:10.1590/1806-9282.20251486

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ORIGINAL ARTICLE • Rev. Assoc. Med. Bras. 72 (2) • 2026 • https://doi.org/10.1590/1806-9282.20251486 linkcopy

The effect of preoperative melatonin patches on sleep quality in patients undergoing urological surgery

Authorship SCIMAGO INSTITUTIONS RANKINGS

OBJECTIVE: The aim of this study was to determine the effects of transdermal melatonin patches on sleep quality in patients undergoing urological surgery.

METHODS: This study is a randomized controlled trial. Fifty-seven patients hospitalized in the urology department of a university hospital in Istanbul were included. Patients were randomly assigned to two groups (melatonin and control). Patients in the melatonin group received transdermal melatonin containing 7 mg of melatonin at 11:00 PM in a quiet, darkened room the night before surgery.

RESULTS: According to the results of this study, Richards-Campbell Sleep Scale sleep-quality scores increased significantly in the melatonin group (p<0.001). The control group showed lower sleep-quality scores. In addition, a statistically significant decrease was observed between the visual analog scale well-being scores before and after the application in the melatonin group (p<0.001).

CONCLUSION: In this study, our results showed that melatonin patches improved sleep quality and psychological well-being in patients undergoing urological surgery.

KEYWORDS:
Melatonin; Well-being; Sleep quality; Urological surgery.

	Melatonin		Control		p-value
	Mean±SD		Mean±SD		p-value
Age	51.41±17.33		50.40±16.83		0.987m
BMI (kg/m²)	27.15±5.15		26.80±2.73		0.755t
	n	%	n	%
Sex
Women	6	22.22%	6	20.0%	0.837x2
Men	21	77.78%	24	80.0%	0.837x2
Marital status
Married	18	66.67%	13	43.3%	0.077x2
Single	9	33.33%	17	56.7%	0.077x2
Education level
Primary	12	44.44%	6	20.0%	0.047 x2
High school and above	15	55.56%	24	80.0%	0.047 x2
Chronic disease
Hypertension	3	11.11%	4	13.3%	0.249x2
Heart disease	4	14.81%	9	30.0%
Diabetes mellitus	4	14.81%	7	23.3%
No chronic disease	16	59.26%	10	33.3%
Smoking
No	17	62.96%	13	43.3%	0.138x2
Yes	10	37.04%	17	56.7%	0.138x2
Surgery type
Varicocelectomy	5	18.52%	10	33.3%	0.634x2
Transurethral resection of the prostate	11	40.74%	9	30.0%
Nephrectomy	6	22.22%	6	20.0%
Radical prostatectomy	5	18.52%	5	16.7%
Surgery experience
No	10	37.04%	3	10.0%	0.015 x2
Yes	17	62.96%	27	90.0%	0.015 x2

	Melatonin			Control			p-value
	Mean±SD			Mean±SD			p-value
VAS before	38.15	±	20.39	37.33	±	16.17	0.858m
VAS after	16.85	±	10.67	29.00	±	12.96	<0.001 m
p-value within group	<0.001 w			<0.001 w
Sleep depth before	37.78	±	15.59	33.67	±	12.79	0.440m
Sleep depth after	65.37	±	26.85	31.5	±	13.59	<0.001t
p-value within group	<0.001 w			0.079 w
Sleep onset latency before	35.74	±	15.42	31.17	±	14.06	0.247t
Sleep onset latency after	60.56	±	28.53	31.00	±	14.04	<0.001 t
p-value within group	<0.001 w			0.564w
Awakenings before	41.11	±	14.16	33.83	±	14.36	0.080m
Awakenings after	80.00	±	27.17	32.50	±	13.76	<0.001 m
p-value within group	<0.001 w			0.161w
Returning to sleep before	38.89	±	13.40	30.83	±	12.32	0.025 m
Returning to sleep after	71.85	±	26.72	31.17	±	12.64	<0.001 m
p-value within group	<0.001 w			0.608w
Overall sleep quality before	37.78	±	12.73	29.33	±	12.37	0.019 m
Overall sleep quality after	68.70	±	27.41	29.83	±	12.63	<0.001 m
p-value within group	<0.001 w			0.571w
RCSS sleep score before	38.26	±	12.72	31.07	±	11.50	0.029 t
RCSS sleep score after	69.33	±	23.33	30.60	±	11.59	<0.001 m
p-value within group	<0.001 w			0.215w

Scale	Factors	Unstandardized coefficients		Standardized coefficients
Scale	Factors	B	SE	Β	t	p
RCSS	Education level	-11.85	7.454	-0.21	-1.59	0.118
RCSS	Surgical experience	-13.322	8.252	-0.213	-1.614	0.112
	Factors	B	SE	Β	t	p
VAS	Education level	8.397	3.656	0.296	2.297	0.025
VAS	Surgical experience	1.713	4.234	0.054	0.405	0.687

Variable	Melatonin group Mean±SD	Control group Mean±SD	Test	p	Cohen’s d
VAS before	38.15±20.39	37.33±16.17	M	0.858	0.04
VAS after	16.85±10.67	29.00±12.96	M	<0.001	1.01
RCSS before total	38.26±12.72	31.07±11.50	T	0.029	0.59
RCSS after total	69.33±23.33	30.60±11.59	M	<0.001	2.07

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[1] BMI: body mass index;

[T1FN1] ^x²Pearson’s chi-square test; SD: standard deviation;

[T1FN1m] ^mMann-Whitney U test;

[T1FN1t] ^tt-test. Bold values indicate statistically significant results (p<0.05).