Melatonin vs. dexmedetomidine for sleep induction in children before electroencephalography

Peganc, Katja (author), Neubauer, David (author), Oražem, Jasna (author), Perković-Benedik, Mirjana (author), Mahne, Urška (author), Bizjak, Neli (author), Rener-Primec, Zvonka (author), Šuštar, Nataša (author), Butenko, Tita (author), Vrščaj, Eva (author), Osredkar, Damjan (author)

Background and objectives: In children requiring electroencephalography (EEG), sleep recording can provide crucial information. As EEG recordings during spontaneous sleep are not always possible, pharmacological sleepinducing agents are sometimes required. The aim of the study was to evaluate safety and efficacy of melatonin (Mel) and dexmedetomidine (Dex; intranasal and sublingual application) for sleep induction prior to EEG. Methods: In this prospective randomized study, 156 consecutive patients aged 1–19 years were enrolled and randomized by draw into melatonin group (Mel; n = 54; dose: 0.1 mg/kg), dexmedetomidine (Dex) sublingual group (DexL; n = 51; dose: 3 mcg/kg) or dexmedetomidine intranasal group (DexN; n = 51; dose: 3 mcg/kg). We compared the groups in several parameters regarding efficacy and safety and also carried out a separate analysis for a subgroup of patients with complex behavioral problems. Results: Sleep was achieved in 93.6% of participants after the first application of the drug and in 99.4% after the application of another if needed. Mel was effective as the first drug in 83.3% and Dex in 99.0% (p < 0.001); in the subgroup of patients with complex developmental problems Mel was effective in 73.4% and Dex in 100% (p < 0.001). The patients fell asleep faster after intranasal application of Dex than after sublingual application (p = 0.006). None of the patients had respiratory depression, bradycardia, desaturation, or hypotension. Conclusions: Mel and Dex are both safe for sleep induction prior to EEG recording in children. Dex is more effective compared to Mel in inducing sleep, also in the subgroup of children with complex behavioral problems.

• Language: English
• Keywords: melatonin, dexmedetomidine, electroencephalography, EEG, sleep, sleep induction
• Work type: Article
• Typology: 1.01 - Original Scientific Article
• Organization: MF - Faculty of Medicine
• Publication status: Published
• Publication version: Version of Record
• Year: 2024
• Number of pages: 7 str.
• Numbering: Vol. 12, art. 1362918
• PID: 20.500.12556/RUL-183265
• UDC: 616-053.2
• ISSN on article: 2296-2360
• DOI: 10.3389/fped.2024.1362918
• COBISS.SI-ID: 195713539
• Publication date in RUL: 10.06.2026

Record is a part of a journal

• Title: Frontiers in pediatrics
• Shortened title: Front. pediatr.
• Publisher: Frontiers Media S.A.
• ISSN: 2296-2360
• COBISS.SI-ID: 523096601

Licences

• License: CC BY 4.0, Creative Commons Attribution 4.0 International
• Link: http://creativecommons.org/licenses/by/4.0/
• Description: This is the standard Creative Commons license that gives others maximum freedom to do what they want with the work as long as they credit the author.