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Relationship Between Dexamethasone Therapy and Sleep Quality, Insomnia, and Melatonin Levels in Patients With Brain Tumors

Dessika Rahmawati, M. Biomed, D. S. Ratih, S. Kurniawan, S. Andarini

Sleep Medicine Research, 2026

66 participants

Abstract

Background and Objective Dexamethasone is a corticosteroid commonly used in patients with brain tumors to manage vasogenic edema and intracranial pressure. However, it is often associated with sleep disturbances that can impair patients’ quality of life. This study aimed to evaluate the relationship between dexamethasone therapy and sleep disorders using the Pittsburgh Sleep Quality Index (PSQI), Insomnia Severity Index (ISI), and serum melatonin levels in patients with brain tumors.Methods A cross-sectional study was conducted involving 66 patients with brain tumors at Saiful Anwar General Hospital, Malang. Subjects were divided into two groups: dexamethasone users and non-users. Sleep quality was assessed using PSQI and ISI, while melatonin levels were analyzed from blood samples drawn during daytime (11:00–12:00 am).Results The dexamethasone group had significantly higher PSQI (p=0.006) and ISI (p<0.001) scores, indicating worse sleep quality and greater insomnia severity compared to non-users. However, there was no significant association between melatonin levels and dexamethasone use (p=0.131).Conclusions Dexamethasone therapy is associated with impaired sleep quality and increased insomnia severity in brain tumor patients. However, no significant correlation was found between melatonin levels and sleep disturbances. The daytime sampling of melatonin may have limited the hormonal assessment. Further studies with nocturnal sampling are recommended.

How strong is the evidence?

Evidence Hub reads this as a cross-sectional, done in people. Its evidence level is 4 of 5 (Low · observational). Observational designs can show an association but not prove cause. Reported size: 66 participants or records.

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