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l -5-Hydroxytryptophan treatment of sleep terrors in children

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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.

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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

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Authors and Affiliations

  1. Centre for Paediatric Sleep Disorders, Department of Developmental Neurology and Psychiatry, University of Rome “La Sapienza”, Via dei Sabelli 108, 00185 , Rome, Italy

    Oliviero Bruni & Elisabetta Verrillo

  2. Sleep Research Centre, Department of Neurology, Oasi Institute for Research on Mental Retardation and Brain Aging (IRCCS), Troina, Italy

    Raffaele Ferri & Silvia Miano

Authors
  1. Oliviero Bruni
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  2. Raffaele Ferri
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  3. Silvia Miano
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  4. Elisabetta Verrillo
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Correspondence to Oliviero Bruni.

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Bruni, O., Ferri, R., Miano, S. et al. l -5-Hydroxytryptophan treatment of sleep terrors in children. Eur J Pediatr 163, 402–407 (2004). https://doi.org/10.1007/s00431-004-1444-7

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  • DOI: https://doi.org/10.1007/s00431-004-1444-7

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