Platelet count and sleep quality in immune thrombocytopenia: correlation with 5-hydroxytryptamine and therapeutic implications of platelet-5-HT-melatonin axis dysregulation

ITP-associated thrombocytopenia disrupts sleep architecture through serotonergic dysregulation and chronic inflammation. Standard glucocorticoid therapy not only restores platelet counts but also ameliorates sleep quality and fatigue, highlighting the therapeutic potential of platelet-targeted interventions for comorbid sleep disorders. These findings advocate for routine sleep assessment in ITP management and integration of 5-HT-modulating strategies into comprehensive care frameworks to address the hematologic-immunologic-sleep axis.