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DOI: 10.1055/s-0030-1267920
© Georg Thieme Verlag KG Stuttgart · New York
Melatonin: Experience in its Use for Recording Sleep EEG in Children and Review of the Literature
Publication History
received 16.02.2010
accepted 29.09.2010
Publication Date:
17 November 2010 (online)
![](https://www.thieme-connect.de/media/neuropediatrics/201004/lookinside/thumbnails/10.1055-s-0030-1267920-1.jpg)
Abstract
Background: Sleep is known to improve the yield of EEG recording in children but is often difficult to obtain. In order to evaluate the efficacy and to test the practability of oral melatonin in obtaining sleep for EEG recording, we studied its use in 70 children.
Results: Sleep was obtained in 56 children (80%) with a mean sleep latency onset of 25±7.9 min (15–45) after melatonin administration, and a mean sleep duration of 17.1±8.6 min (5–55). 28 children (50%) woke up spontaneously after 13.2±7.9 min (5–40). Among 18 children with severe behaviour problems that made interpretable EEG recording in the awake state impossible, sleep was obtained in 13 (72%) children. The rare symtoms reported (4%) were not reliably related to the use of melatonin.
Conclusion: The study shows a very good efficacy in sleep induction for EEG recording, even in children with severe behaviour problems. Sleep duration was, however, short with a high proportion of spontaneous arousals but in all patients it was sufficient for an initial diagnosis or control of the evolution of epilepsy.
Key words
melatonin - sleep EEG - epilepsy
References
- 1 Arendt J. Safety of melatonin in long-term use. J Biol Rhythms. 1997; 12 673-681
- 2 Ashrafi MR, Mohammadi M, Tafarroji J. et al . Melatonin versus chloral hydrate for recording sleep EEG. Eur J Paed Neurol. 2009; Epub ahead of print
- 3 Blask DE, Sauer LA, Dauchy RT. Melatonin as a chronobiotic/anticancer agent: cellular, biochemical and molecular mechanisms of action and their implications for circadian-based cancer therapy. Curr Top Med Chem. 2002; 2 113-132
- 4 Buscemi N, Vandermeer B, Hooton N. et al . Efficacy and safety of exogenous melatonin for secondary sleep disorders and disorders accompanying sleep restriction: meta-analysis. BMJ. 2006; 332 385-393
- 5 Davis FC. Melatonin: role in development. J Biol Rhythms. 1997; 12 498-508
- 6 Dodge NN, Wilson GA. Melatonin for tretament of sleep disorders in children with developmental disabilities. J Child Neurol. 2001; 16 581-584
- 7 Espezel H, Graves C, Jan JE. et al . Melatonin as a sedation substitute for diagnostic procedures. Dev Med Child Neurol. 2000; 42 646-648
- 8 Fenoglio-Simeone K, Mazarati A, Sefidvash-Hockley S. et al . Anticonvulsant effects of the selective melatonin receptor agonist ramelteon. Epilepsy Behav. 2009; 16 52-57
- 9 Gitto E, Karbownik M, Reiter RJ. et al . Effects of melatonin treatment in septic newborns. Pediatr Res. 2001; 50 756-760
- 10 Gordon N. The therapeutics of melatonin: a paediatric perspective. Brain Dev. 2000; 22 213-217
- 11 Herrera J, Nava M, Romero F. et al . Melatonin prevents oxidative stress resulting from iron and erythropoietin administration. Am J Kidney Dis. 2001; 37 750-757
- 12 Jan JE, Espezel H, Appleton RE. The treatment of sleep disorders with melatonin. Dev Med Child Neurol. 1994; 36 97-107
- 13 Jan JE, Freeman RD. Melatonin therapy for circadian rhythm sleep disorders in children with multiple disabilities: what have we learned in the last decade?. Dev Med Child Neurol. 2004; 46 776-782
- 14 Johnson K, Page A, Williams H. et al . The use of melatonin as an alternative to sedation in uncooperative children undergoing an MRI examination. Clinical Radiology. 2002; 57 502-506
- 15 Jones C, Huyton M, Hindley D. Melatonin and epilepsy. Arch Dis Child. 2005; 90 1202-1209
- 16 Lemus-Wilson A, Kelly PA, Blask DE. Melatonin blocks the stimulatory effets of prolactin on human breast cancer cell growth in culture. Br J Cancer. 1995; 72 1435-1440
- 17 Lerner AB, Case JD, Takahashi Y. Isolation of melatonin and 5-methoxyindole-3-acetic acid from bovine pineal glands. J Biol Chem. 1960; 235 1992-1997
- 18 Lewiński A, Zelazowski P, Sewerynek E. et al . Melatonin-induced suppression of human lymphocyte natural killer activity in vitro. J Pineal Res. 1989; 7 153-164
- 19 Lissoni P, Chilelli M, Villa S. et al . Five years survival in metastatic non-small cell lung cancer patients treated with chemotherapy alone or chemotherapy and melatonin: a randomized trial. J Pineal Res. 2003; 35 12-15
- 20 Luboshitzky R, Levi M, Shen-Orr Z. et al . Long-term melatonin administration does not alter pituitary-gonadal hormone secretion in normal men. Hum Reprod. 2000; 16 60-65
- 21 Maestroni GJ. The immunoneuroendocrine role of melatonin. J Pineal Res. 1993; 14 1-10
- 22 Marczynski TJ, Yamaguchi N, Ling GM. et al . Sleep induced by the administration of melatonin (5-methoxy-N-acetyltryptamine) to the hypothalamus in unrestrained cats. Experientia. 1964; 20 435-437
- 23 McArthur AJ, Budden SS. Sleep dysfunction in Rett syndrome: A trial of exogenous melatonin treatment. Dev Med Child Neurol. 1998; 40 186-192
- 24 Mevissen M, Ebert U. Anticonvulsant effects of melatonin in amygdala-kindled rats. Neurosci Lett. 1998; 257 13-16
- 25 Middleton BA, Stone BM, Arendt J. Melatonin and fragmented sleep patterns. Lancet. 1996; 348 (9026) 551-552
- 26 Milstein V, Small JG, Spencer DW. Melatonin for Sleep EEG. Clin Electroencephalography. 1998; 29 49-53
- 27 Molina Carballo A, Munoz-Hoyos A, Reiter RJ. et al . Utility of high doses of melatonin as adjunctive anticonvulsant therapy in a child with severe myoclonic epilepsy: two years’ experience. J Pineal Res. 1997; 23 97-105
- 28 Muños-Holos A, Sachez-Forte M, Molina-Carballo A. et al . Melatonin's role as an anticonvulsant and neuronal protector: experimental and clinical evidence. J Child Neurol. 1998; 13 501-509
- 29 Naguib M, Samarkandi AH. Premedication with melatonin: a double-blind, placebo-controlled comparison with midazolam. Br J Anaesthesia. 1999; 82 875-880
- 30 Peled N, Shorer Z, Peled E. et al . Melatonin effect on seizures in children with severe neurologic deficit disorders. Epilepsia. 2001; 42 1208-1210
- 31 Pillar G, Etzioni A, Shahar E. et al . Melatonin treatment in an institutionalised child with psychomotor retardation and an irregular sleep-wake pattern. Arch Dis Child. 1998; 79 63-64
- 32 Rechtschaffen A, Kales A. A manual of standardized terminology, techniques and scoring system for sleep stages in human subjects. Bethesda, MD: National Institute of Neurological Diseases and Blindness, US Government Printing Office, NIH Publication No. 168 1968 204
- 33 Samarkandi A, Naguib M, Riad W. et al . Melatonin vs. midazolam premedication in children: a double-blind, placebo-controlled study. Eur J Anaesthesiol. 2005; 22 189-196
- 34 Schmidt CM, Bohlender JE, Deuster D. et al . Melatonin als Alternative zur Sedierung bei Durchführung einer Hirnstammaudiometrie bei Kindern. Laryngo-Rhino-Otol. 2004; 83 523-528
- 35 Schmidt CM, Knief A, Deuster D. et al . Melatonin is a useful alternative to sedation in children undergoing brainstem audiometry with an age dependent success rate – a field report of 250 investigations. Neuropediatrics. 2007; 38 2-4
- 36 Seabra ML, Bignotto M, Pinto Jr LR. et al . Randomized, double-blind clinical trial, controlled with placebo, of the toxicology of chronic melatonin treatment. J Pineal Res. 2000; 29 193-200
- 37 Sheldon SH. Pro-convulsant effects on oral melatonin in neurologically disabled children. Lancet. 1998; 351 1254
- 38 Solmaz I, Gürkanlar D, Gökçil Z. et al . Antiepileptic activity of melatonin in guinea pigs with pentylenetetrazol-induced seizures. Neurol Res.. 2009; 31 989-995
- 39 Stanberry LR, Das Gupta TK, Beattie CW. Photoperiodic control of melanomal growth in hamsters: influence of pinealectomy and melatonin (abstract). Endocrinology. 1983; 113 469-475
- 40 Turk J. Melatonin supplementation for severe and intractable sleep disturbance in young people with genetically determined developmental disabilities: short review and commentary. J Med Genet. 2003; 40 793-796
- 41 Waldron DL, Bramble D, Gringras P. Melatonin: prescribing practices and adverse events. Arch Dis Child. 2005; 90 1206-1207
- 42 Wassmer E, Quinn E, Seri S. et al . Easy sleep with melatonin. Arch Dis Child. 2000; 82 (suppl. 1) A40-A41
- 43 Wassmer E, Fogarty M, Page A. et al . Melatonin as a sedation substitute for diagnostic procedure: MRI and EEG. Dev Med Child Neurol. 2001; 43 136
- 44 Wassmer E, Quinn E, Whitehouse W. et al . Melatonin as a sleep inductor for electroencephalogram recordings in children. Clin Neurophysiol. 2001; 112 683-685
- 45 Wassmer E, Carter PFB, Quinn E. et al . Melatonin is useful for recording sleep EEGs: a prospective audit of outcome. Dev Med Child Neurol. 2001; 43 735-738
- 46 Wiechmann AF, O’Steen WK. Melatonin increases photoreceptor susceptibility to light-induced damage. Invest Ophthalmol Vis Sci. 1992; 33 1894-1902
- 47 Willey C, Phillips B. Is melatonin likely to help children with neurodevelopmental disability and chronic severe sleep problems?. Arch Dis Child. 2002; 87 260
- 48 Yildirim M, Marangoz C. Anticonvulsant effects of melatonin on penicillin-induced epileptiform activity in rats. Brain Res. 2006; 1099 183-188
- 49 Zhdanova IV, Wurtman RJ, Wagstaff J. Effects of a low dose of melatonin on sleep in children with Angelman syndrome. J Pediatr Endocrinol Metab. 1999; 12 57-67
Correspondence
Monika Eisermann
Saint Vincent de Paul Hospital
Clinical Neurophysiology
82 Avenue Denfert Rochereau
75015 Paris
France
Phone: +33/6/8930 4124
Fax: +33/1/4048 8371
Email: monika.eisermann@svp.aphp.fr