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

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Dessika Rahmawati, Dwita Sukmala Ratih, Shahdevi Nandar Kurniawan, Sri Andarini

2026 Sleep Medicine Research Vol. 17 Issue 1 Article Cited by 0 Quartile

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. © 2026 The Korean Society of Sleep Medicine. This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (https://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Affiliations

Doctoral Program of Medical Science, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia; Department of Neurology, Brawijaya University, Dr. Saiful Anwar Hospital, Malang, Indonesia; Department of Public Health Medicine, Brawijaya University, Malang, Indonesia