title: Comparative Study between the use of Melatonin and A Solution with Melatonin, Tryptophan, and Vitamin B6 as an Inducer of Spontaneous Sleep in Children During an Auditory Response Test: An Alternative to Commonly Used Sedative Drugs.
abstract: OBJECTIVE
  An elective investigation into the early diagnosis of deafness in children under the age of 4-5 years is performed using auditory evoked potentials of auditory brainstem responses (ABRs). In case of pediatric patients, the major difficulty includes being examined during spontaneous sleep, which is complicated to obtain, especially in the age range of 12 to 72 months. Recently, melatonin has been used as a "sleep inducer" in diagnostic tests with positive results. Our aim was to evaluate the use of melatonin and of a solution containing melatonin, tryptophan, and vitamin B6 as an inducer of spontaneous sleep on repeated ABR analyses as well as to evaluate the reduction in analyses with sedative drugs in case of uncooperative patients.
  
  
  METHODS
  In total, 748 children aged between 12 and 48 months were included in the study and divided into three groups: A: placebo (n=235), B: melatonin (n=246), and C: melatonin, tryptophan, and vitamin B6 (n=267).
  
  
  RESULTS
  In groups B and C, in addition to physiological awakening, we observed a significant reduction in the number of repeated analyses as well as drug regimen usage.
  
  
  CONCLUSIONS
  This study confirms the strategic role of melatonin as an inducer of spontaneous sleep. However, above all, it suggests that the administration of a solution containing melatonin, tryptophan, and vitamin B6 significantly reduces the number of repeated ABR examinations as well as the percentage of repeated analysis performed using sedative drugs compared to both the control group and the melatonin-only group.
authors.affiliation: Santobono-Pausilipon Pediatric Hospital, Otololgy and Cochlear Implant Unit, Napoli, Italy. antoniodellavolpe@yahoo.it.
authors.forename: Antonio Della
authors.initials: AD
authors.lastname: Volpe
authors.forename: Antonietta De
authors.initials: A
authors.lastname: Lucia
authors.forename: Clementina
authors.initials: C
authors.lastname: Pirozzi
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Pastore
mesh_terms: D001300:Audiometry, Evoked Response / Q000379:methods; D002648:Child; D002675:Child, Preschool; D003638:Deafness / Q000175:diagnosis / Q000209:etiology; D004338:Drug Combinations; D042241:Early Diagnosis; D004569:Electroencephalography; D016057:Evoked Potentials, Auditory, Brain Stem; D005260:Female; D034381:Hearing Loss / Q000150:complications / Q000175:diagnosis*; D006320:Hearing Tests; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage*; D008297:Male; D008550:Melatonin / Q000008:administration & dosage*; D014364:Tryptophan / Q000008:administration & dosage*; D025101:Vitamin B 6 / Q000008:administration & dosage*
chemical_list: D004338:Drug Combinations; D006993:Hypnotics and Sedatives; D025101:Vitamin B 6; D014364:Tryptophan; D008550:Melatonin