Association of sleep quality and urinary melatonin levels with endometrial cancer: A case control pilot study

Endometrial cancer is the most common gynecologic malignancy globally. Recent studies suggest that alterations in circadian rhythm might be associated with an increased risk of endometrial carcinoma. To evaluate the association between sleep quality, urinary melatonin levels, and prevalence of endometrial cancer. A case control study was conducted among perimenopausal women with recently diagnosed endometrial cancer. Women with no history of cancer were recruited as controls. Sleep evaluation was done using the Pittsburgh Sleep Quality Index (PSQI). Urinary melatonin levels were measured using liquid chromatography tandem mass spectrometry methods. The sociodemographic variables (age, education, occupation, and diet) as well as the variables of PSQI scores and melatonin levels were compared between cases and healthy controls. The mean ± SD age of cases was 50.7 ± 11.2 (n = 18), and it does not differ significantly from the controls, 48.2 ± 2.6 (n = 18). The PSQI global scores mean (SD) among cases, 8.77 ± 3.76, was significantly higher as compared to controls, 6.27 ± 2.71 (P = 0.03). The sleep onset latency was significantly higher among patients (P = 0.002), and sleep duration scores are significantly different between cases and controls (P = 0.006). The melatonin level mean ± SD among cases, 6.72 ± 2.71 ng/mL, was significantly low as compared to controls, 12.38 ± 6.64 ng/mL (P = 0.006). Low melatonin levels along with sleep quality in endometrial carcinoma patients indicate that the malignancy might be associated with disturbances in the circadian rhythm.