Sleep deprivation and melatonin for inducing sleep in paediatric electroencephalography: a prospective multicentre service evaluation.
Study Goal
The researchers aimed to compare the efficacy of different sleep induction methods (sleep deprivation, melatonin, and combined sleep deprivation/melatonin) for achieving sleep and detecting EEG abnormalities in children.
Results Summary
The study found that combined sleep deprivation/melatonin was more effective (90% success rate) in achieving stage II sleep than either method alone (69% for sleep deprivation, 77% for melatonin). There was no significant difference in the occurrence of epileptiform abnormalities between the methods.
Population
Children aged 1-17 years (mean 7y 10mo), including 27.7% with underlying neurobehavioural conditions.
Effective Dosage
Not specified
Duration
Not specified
Interactions
None mentioned
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
sleep deprivation | increase | stage II sleep | children | 69 per cent | achieved | #1 |
melatonin | increase | stage II sleep | children | 77 per cent | achieved | #2 |
combined sleep deprivation/melatonin | increase | stage II sleep | children | 90 per cent | achieved | #3 |
combined sleep deprivation/melatonin | increase | sleep | children | - | is more effective than either method alone in achieving sleep | #4 |
combined sleep deprivation/melatonin | increase | sleep | children | - | is more effective in achieving sleep than either sleep deprivation or melatonin alone | #5 |
combined sleep deprivation/melatonin | decrease | sleep latency | children | - | shorter | #6 |
sleep deprivation | no change | occurrence of epileptiform activity during sleep | children | - | broadly similar | #7 |
melatonin | no change | occurrence of epileptiform activity during sleep | children | - | broadly similar | #8 |
combined sleep deprivation/melatonin | no change | occurrence of epileptiform activity during sleep | children | - | broadly similar | #9 |
sleep deprivation | no change | occurrence of epileptiform abnormalities | children | - | no difference | #10 |
melatonin | no change | occurrence of epileptiform abnormalities | children | - | no difference | #11 |
combined sleep deprivation/melatonin | no change | occurrence of epileptiform abnormalities | children | - | no difference | #12 |
AIM: To compare the efficacy of the main methodologies in attaining sleep and electroencephalography (EEG) abnormalities in children with a view to producing recommendations on best practice. METHOD: Fifty-one UK centres participated. Methods for sleep induction (sleep deprivation, melatonin, and combined sleep deprivation/melatonin) were compared. Data pertaining to demographics, achievement of stage II sleep, and recording characteristics (duration of study, presence of epileptiform activity in awake/sleep states) were prospectively collected for consecutive patients in November and December 2013. RESULTS: Five hundred and sixty-five patients were included. Age range was 1 years to 17 years (mean 7y 10mo), 27.7 per cent had an underlying neurobehavioural condition. Stage II sleep was achieved in 69 per cent of sleep deprived studies, 77 per cent of melatonin studies, and 90 per cent of combined intervention studies (p<0.001, χ INTERPRETATION: Combined sleep deprivation/melatonin is more effective than either method alone in achieving sleep. The occurrence of epileptiform activity during sleep is broadly similar across the three groups. We recommend the combined intervention to induce sleep for paediatric EEG. WHAT THIS PAPER ADDS: Combined sleep deprivation/melatonin is more effective in achieving sleep than either sleep deprivation or melatonin alone. Sleep latency is shorter with combined sleep deprivation/melatonin. When children do sleep, there is no difference in the occurrence of epileptiform abnormalities between different induction methods. Seizures are rare in sleep electroencephalography recordings.