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The role of melatonin in the effective attainment of electroencephalograms in children in a Sub-Saharan setting
Rationale: The paucity of access to electroencephalograms (EEGs) in sub-Saharan Africa results in a high patient load attending the few centres with neurophysiology units. Sleep state for EEGs performed on children improves yield and reduces artefact. Melatonin induces “natural sleep” without the ri...
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| Format: | Thesis |
| Language: | English |
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Division of Neurology
2019
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| _version_ | 1867613281353465856 |
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| access_status_str | Open Access |
| author | Chidi, Ibekwe Roland |
| author2 | Wilmshurst, Joanne M |
| author_browse | Chidi, Ibekwe Roland Wilmshurst, Joanne M |
| author_facet | Wilmshurst, Joanne M Chidi, Ibekwe Roland |
| author_sort | Chidi, Ibekwe Roland |
| collection | Thesis |
| description | Rationale: The paucity of access to electroencephalograms (EEGs) in sub-Saharan Africa results in a high patient load attending the few centres with neurophysiology units. Sleep state for EEGs performed on children improves yield and reduces artefact. Melatonin induces “natural sleep” without the risk of airway compromise. This study evaluated the effectiveness of oral melatonin in attainment of useful electroencephalograms in South African children.
Methods: Consecutive children booked for routine EEG who were either unable to cooperate or were referred for sleep EEG received oral melatonin (3mg < 15kg; 6mg > 15kg) (September 2013-March 2014). Comparison was made to a retrospective control group who received the previous sleep protocol agent, chloral hydrate. Outcome measures were the proportion of children who achieved sleep, useful EEG study data, sleep latency and duration, presence and level of artifacts and presence of recorded EEG study abnormalities.
Results: 173 children were recruited, 88 (51%) male, median age 4 years 9 months (interquartile range of 2 years 2 months – 7 years 6 months). 87% of the children achieved stage 2 sleep and were deemed to have successfully entered sleep state. The median sleep latency was 44.5 minutes and the duration of sleep was 25 minutes (range 18.5 – 29 minutes). Children showed no signs of post-sedation irritability or persistent drowsiness. They were awoken and were immediately able to go home. In the melatonin group there were no adverse events, and no child needed their study deferred due to inter-current illnesses. All children administered melatonin cooperated and permitted a successful EEG recording with useful records even if sleep was not achieved. Sedation with melatonin was less successful (74% compared to 88%) in children with developmental and behavioural problems (χ 2 = 6.18, P= 0.046), they also had higher rate of artifacts (χ 2 = 5.83, P=0.05). 33.5% of the study group children (n=58) had abnormal EEG studies. These outcomes were comparable to a historical cohort of age equivalent children who were sedated with chloral hydrate (45.5%) (χ 2 = 1.22, P= 1.27). 79% that received melatonin compared with 86% of those that were sedated with chloral hydrate had artifacts (χ 2 = 0.63, P= 0.42)
Conclusion: Melatonin is effective and safe in inducing sleep for EEG recording in our setting. |
| format | Thesis |
| id | oai:open.uct.ac.za:11427/29444 |
| institution | University of Cape Town (South Africa) |
| language | eng |
| last_indexed | 2026-06-10T12:33:37.862Z |
| license_str | Not specified — see source repository |
| provenance_str_mv | Harvested via OAI-PMH from UCTD — University of Cape Town Open Access Repository |
| publishDate | 2019 |
| publishDateRange | 2019 |
| publishDateSort | 2019 |
| publisher | Division of Neurology |
| publisherStr | Division of Neurology |
| record_format | dspace |
| source_str | UCTD — University of Cape Town Open Access Repository |
| spelling | oai:open.uct.ac.za:11427/29444 The role of melatonin in the effective attainment of electroencephalograms in children in a Sub-Saharan setting Chidi, Ibekwe Roland Wilmshurst, Joanne M Paediatric Neurology Rationale: The paucity of access to electroencephalograms (EEGs) in sub-Saharan Africa results in a high patient load attending the few centres with neurophysiology units. Sleep state for EEGs performed on children improves yield and reduces artefact. Melatonin induces “natural sleep” without the risk of airway compromise. This study evaluated the effectiveness of oral melatonin in attainment of useful electroencephalograms in South African children. Methods: Consecutive children booked for routine EEG who were either unable to cooperate or were referred for sleep EEG received oral melatonin (3mg < 15kg; 6mg > 15kg) (September 2013-March 2014). Comparison was made to a retrospective control group who received the previous sleep protocol agent, chloral hydrate. Outcome measures were the proportion of children who achieved sleep, useful EEG study data, sleep latency and duration, presence and level of artifacts and presence of recorded EEG study abnormalities. Results: 173 children were recruited, 88 (51%) male, median age 4 years 9 months (interquartile range of 2 years 2 months – 7 years 6 months). 87% of the children achieved stage 2 sleep and were deemed to have successfully entered sleep state. The median sleep latency was 44.5 minutes and the duration of sleep was 25 minutes (range 18.5 – 29 minutes). Children showed no signs of post-sedation irritability or persistent drowsiness. They were awoken and were immediately able to go home. In the melatonin group there were no adverse events, and no child needed their study deferred due to inter-current illnesses. All children administered melatonin cooperated and permitted a successful EEG recording with useful records even if sleep was not achieved. Sedation with melatonin was less successful (74% compared to 88%) in children with developmental and behavioural problems (χ 2 = 6.18, P= 0.046), they also had higher rate of artifacts (χ 2 = 5.83, P=0.05). 33.5% of the study group children (n=58) had abnormal EEG studies. These outcomes were comparable to a historical cohort of age equivalent children who were sedated with chloral hydrate (45.5%) (χ 2 = 1.22, P= 1.27). 79% that received melatonin compared with 86% of those that were sedated with chloral hydrate had artifacts (χ 2 = 0.63, P= 0.42) Conclusion: Melatonin is effective and safe in inducing sleep for EEG recording in our setting. 2019-02-08T14:14:46Z 2019-02-08T14:14:46Z 2018 2019-02-07T07:38:36Z Master Thesis Masters MPhil http://hdl.handle.net/11427/29444 eng application/pdf Division of Neurology Faculty of Health Sciences University of Cape Town |
| spellingShingle | Paediatric Neurology Chidi, Ibekwe Roland The role of melatonin in the effective attainment of electroencephalograms in children in a Sub-Saharan setting |
| thesis_degree_str | Master's |
| title | The role of melatonin in the effective attainment of electroencephalograms in children in a Sub-Saharan setting |
| title_full | The role of melatonin in the effective attainment of electroencephalograms in children in a Sub-Saharan setting |
| title_fullStr | The role of melatonin in the effective attainment of electroencephalograms in children in a Sub-Saharan setting |
| title_full_unstemmed | The role of melatonin in the effective attainment of electroencephalograms in children in a Sub-Saharan setting |
| title_short | The role of melatonin in the effective attainment of electroencephalograms in children in a Sub-Saharan setting |
| title_sort | role of melatonin in the effective attainment of electroencephalograms in children in a sub saharan setting |
| topic | Paediatric Neurology |
| url | http://hdl.handle.net/11427/29444 |
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