Objectives Study aims in describing a case of insomnia associated with Behcet's disease and responding to treatment with melatonin. Method (case report) Case concerns a 59-year-old female arriving at our outpatient ward complaining of insomnia. Her sleep pattern was disturbed in a way that she has been sleeping for about an hour daily for the last two years. The problem had started five years ago, her sleep progressively deteriorating with time. She also mentioned a feeling of exhaustion being present every day during the last year and lasting all day long, difficulty in concentrating in the performance of everyday activities and also a feeling of hopelessness affecting her daily mood. All of the above were progressing as insomnia was persisting. Her medical history was significant for Behcet's disease diagnosed about 20 years before and being treated with corticosteroids. Results (treatment-outcome) Initially patient was prescribed lorazepam at a dose of 2.5 mg and melatonin 5mg, both once daily before bedtime. After 10 days, patient has started responding, sleep having increased from 1 to 2.5 hours daily. At that time, dose of lorazepam was halved. After altogether 25 days, patient was sleeping for about 5 hours daily, lorazepam was stopped and melatonin was increased at 10mg before bedtime. By the end of the 3rd month and whilst making no further adjustments in medication, patient was sleeping for 6 to 6.5 hours per night. Conclusions Melatonin seemed effective in treating insomnia associated with Behcet's disease, arising either from disease itself or corticosteroid treatment.
N. Kouroumalos, K. Korevi, N. Marketos