title: A comparison of the effect of honey, dextromethorphan, and diphenhydramine on nightly cough and sleep quality in children and their parents.
abstract: OBJECTIVE
  Coughing is a prevalent symptom of upper respiratory infections (URIs) that cause disturbance in the sleep of children and their parents. There is as yet no reliable treatment to control URIs and their related cough; however, drugs such as dextromethorphan (DM) and diphenhydramine (DPH) are now mainly used in the world. The aim of this study is to compare the effect of honey, DM, and DPH on the nightly cough and sleep quality of children and their parents.
  
  
  METHODS
  This was a clinical trial study in which 139 children aged 24-60 months suffering from coughing due to URIs were selected and assigned randomly to 4 groups. The first group received honey (HG), the second one DM (DMG), the third DPH (DPHG), but the fourth group or control group (CG) was assigned to a supportive treatment.
  
  
  METHODS
  After approximately a 24-hour intervention, the 4 groups were reexamined and their cough frequency, cough severity, and sleep quality in children and their parents were recorded by using the questionnaire with Likert-type questions.
  
  
  RESULTS
  The mean of cough frequency score HG is 4.09 +/- 0.72 and 1.93 +/- 0.65 before and after the intervention, respectively, while these figures for the CG are 4.11 +/- 0.78 and 3.11 +/- 0.57, respectively. After the intervention, the difference of the mean score of the variables in all groups became statistically significant. The mean score of all variables in HG has stood significantly higher than those in other groups. There is also a significant relationship between the DMG and CG groups, even though there is no statistically difference between DMG and DPHG groups.
  
  
  CONCLUSIONS
  The result of the study demonstrated that receiving a 2.5-mL dose of honey before sleep has a more alleviating effect on URIs-induced cough compared with DM and DPH doses.
authors.affiliation: Department of Pediatrics, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
authors.forename: Mahmood Noori
authors.initials: MN
authors.lastname: Shadkam
authors.forename: Hassan
authors.initials: H
authors.lastname: Mozaffari-Khosravi
authors.forename: Mohammad Reza
authors.initials: MR
authors.lastname: Mozayan
mesh_terms: D000996:Antitussive Agents / Q000627:therapeutic use*; D056705:Apitherapy; D002675:Child, Preschool; D003371:Cough / Q000188:drug therapy* / Q000209:etiology; D003915:Dextromethorphan / Q000627:therapeutic use*; D004155:Diphenhydramine / Q000627:therapeutic use*; D005260:Female; D006722:Honey; D006801:Humans; D008297:Male; D010290:Parents; D012141:Respiratory Tract Infections / Q000150:complications / Q000188:drug therapy*; D012890:Sleep / Q000187:drug effects*; D013997:Time Factors
chemical_list: D000996:Antitussive Agents; D003915:Dextromethorphan; D004155:Diphenhydramine