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Melatonin supplementation enhances pulmonary rehabilitation outcomes in COPD: a randomized, double-blind, placebo-controlled study

May 2024

Article:  Viana SMDNR, de Bruin VMS, Vasconcelos RS, Nogueira ANC, Mesquita R, de Bruin PFC. Melatonin supplementation enhances pulmonary rehabilitation outcomes in COPD: a randomized, double-blind, placebo-controlled study. Respir Med. 2023 Dec;220:107441. doi: 10.1016/j.rmed.2023.107441. Epub 2023 Nov 7. PMID: 37944829.



This randomized, controlled study of 39 individuals with chronic obstructive pulmonary disease (COPD) undergoing a 12-week Pulmonary Rehabilitation (PR) were evaluated to assess if those taking melatonin had improved scores on their 6-minute walk tests (6MWT), overall health status, and quality of life. Results showed that those undergoing a combination of melatonin supplementation along with PR had improved scores. 


SNHI’s Advisory Council comments/takeaway from the article: 

Melatonin has long been known for its antioxidant potential beyond the traditional use for sleep and circadian rhythm support. There are a number of studies supporting its actions in the lungs, so this study is supportive of melatonin’s journey toward validation for clinical use in lung conditions. Interestingly, all individuals in this study improved their 6 minute walking test to the minimum expected over a 12-week PR program, but the MLT group improved by an additional 67% over the average value reported in a systematic review with meta-analysis of 38 PR studies.*


Article Summary:

Individuals (N=39) suffering from COPD were assigned to a placebo group or given 3 mg melatonin daily throughout the 12-week pulmonary rehabilitation program. Participants were evaluated with a 6-minute walk test (6MWT) to evaluate exercise capacity. A COPD assessment test for overall health status and quality of life, using the airways questionnaire 20, was also done to evaluate the participants over the 12-week PR program.



The group taking 3 mg of melatonin exhibited superiority in the measured elements of the PR program:

·      Distance covered in the 6MWT (71 ± 26 vs. 25 ± 36 m; p < 0.01)

·      Health status (-11 ± 6 vs. -3 ± 5; p < 0.01)

·      Quality of life (-6.9 ± 3.0 vs. -1.9 ± 2.4; p < 0.01)


The authors concluded that: “MLT supplementation during the course of 12 weeks of PR can improve functional capacity, health status and quality of life in patients with COPD. These findings may have significant implications for the management of this condition.”


Limitations noted by Author(s):

Metabolic response to exercise, such as oxygen consumption and measurements of glucose and lactate levels to estimate exercise intensity, were not performed. Changes in body composition were not objectively measured either and could have been beneficial. The small sample size is also a limitation noted.


Other limitations noted in this review: 

Pulmonary function testing would have been an additional measure that could have been utilized for more quantitative data beyond questionnaires that can be subjective.


Article review completed by Mona Fahoum, ND

Content reviewed by Kim Ross, DCN

Date 5/1/2024


*McCarthy B, Casey D, Devane D, Murphy K, Murphy E, Lacasse Y. Pulmonary rehabilitation for chronic obstructive pulmonary disease. Cochrane Database Syst Rev. 2015;2015(2):CD003793. Published 2015 Feb 23. doi:10.1002/14651858.CD003793.pub3

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