European Journal of Pediatrics

, Volume 163, Issue 7, pp 402–407

l -5-Hydroxytryptophan treatment of sleep terrors in children

  • Oliviero Bruni
  • Raffaele Ferri
  • Silvia Miano
  • Elisabetta Verrillo
Original Paper

DOI: 10.1007/s00431-004-1444-7

Cite this article as:
Bruni, O., Ferri, R., Miano, S. et al. Eur J Pediatr (2004) 163: 402. doi:10.1007/s00431-004-1444-7

Abstract

To test the hypothesis that the administration of l -5-hydroxytryptophan ( l -5-HTP) might exert beneficial effects on sleep terrors, we carried out an open pharmacological trial in a group of children with sleep terrors compared to a group of children with the same disorder but without l -5-HTP treatment. Participants in the trial were 45 children (34 males and 11 females; age range 3.2–10.6 years), referred to the Sleep Centre of the Department of Developmental Neurology and Psychiatry of the University of Rome “La Sapienza”, affected by sleep terrors. All subjects underwent: (1) complete medical and sleep history; (2) complete neurological examination and EEG recording whilst awake and sleeping, (3) a structured sleep diary for 2 months, (4) after 1 month, all subjects were examined again from the clinical and EEG points of view and (5) after 6 months, a structured interview in order to evaluate the clinical outcome. After the first visit, l -5-HTP was administered (2 mg/kg per day) at bedtime to 31 randomly selected patients for a single period of 20 consecutive days. After 1 month of treatment, 29/31 (93.5%) of patients showed a positive response. In the comparison group without drug therapy, after 1 month, the episodes disappeared only in four children (28.6%) while ten children (71.4%) showed the persistence of episodes with the same frequency as before. After 6 months, 26/31 (83.9%) of children treated with l -5HTP were sleep terror-free, while in five children (16.1%) sleep terror episodes persisted. Of the children in the comparison group, ten (71.4%) continued to show sleep terrors at 6-month follow-up. Conclusion:to our knowledge, this is the first study demonstrating the efficacy of a new drug treatment for sleep terrors. These results confirm our initial hypothesis and represent evidence that treatment with l -5-hydroxytryptophan is able to modulate the arousal level in children and to induce a long-term improvement of sleep terrors.

Keywords

Arousal disorders l -5-HydroxytryptophanSerotoninergic systemSleep terrors

Abbreviations

EMS

eosinophilia-myalgia syndrome

HSDWA

hypersynchronous high voltage delta waves arousal

HVMD

high voltage monomorphic delta

l -5-HTP

l -5-hydroxytryptophan

NREM

non rapid eye movement

PLMs

periodic limb movements during sleep

SDB

sleep-disordered breathing

Copyright information

© Springer-Verlag 2004

Authors and Affiliations

  • Oliviero Bruni
    • 1
  • Raffaele Ferri
    • 2
  • Silvia Miano
    • 2
  • Elisabetta Verrillo
    • 1
  1. 1.Centre for Paediatric Sleep Disorders, Department of Developmental Neurology and PsychiatryUniversity of Rome “La Sapienza”Rome Italy
  2. 2.Sleep Research Centre, Department of NeurologyOasi Institute for Research on Mental Retardation and Brain Aging (IRCCS)Troina Italy