The Effect of Melatonin on Sleep Quality in Hemodialysis Patients: A Systematic Review and Meta‐Analysis of Randomized Controlled Trials

Background Sleep disturbances are common in adults receiving hemodialysis and are linked to higher mortality risk. Melatonin improves sleep quality in several adult populations based on the Pittsburgh Sleep Quality Index (PSQI), but its benefit in hemodialysis remains unclear. This systematic review and meta‐analysis evaluated melatonin's efficacy compared to placebo on sleep quality in adults undergoing hemodialysis. Methods Randomized controlled trials published up to October 2025 were identified. Data were extracted and quality assessed per Cochrane guidelines. RevMan software was used for analysis. Results Five trials (323 patients) were included. Melatonin improved the global PSQI compared with placebo. Sleep duration and sleep efficiency improved with low heterogeneity. Sleep disturbances improved, and sensitivity analysis preserved the effect despite initial high heterogeneity. Conclusions Melatonin may improve sleep quality in adults receiving hemodialysis, although certainty remains limited. Further trials are needed to establish the optimal dose and duration.