Skip to main content
SpringerLink
Log in

Need for a standardized technique of nap EEG recordings: results of a national online survey in Italy

  • Original Article
  • Published:
Neurological Sciences Aims and scope Submit manuscript

Abstract

The aim of this study is to report current clinical practice for sleep induction in Italian epilepsy centers. We administered an online-structured survey between March and November 2017 and collected data from pediatric and adult neurophysiologists belonging to 73 epilepsy centers. The preferred time for EEG recording is variable, depending on daily schedule of each laboratory. To facilitate spontaneous sleep during nap EEGs, almost all centers require sleep deprivation before the examination, with partial loss preferred to total deprivation in most centers (58/73 vs 12/73, p < 0.001). Other non-pharmacological procedures include breast/bottle feeding or listening to music (encouraged in most centers). Pharmacological sleep induction is performed in 40% of laboratories, more commonly in children than in adults (27/60 vs 7/42, p = 0.003). Melatonin is the most frequently prescribed drug to facilitate spontaneous sleep (one third of participating centers). Our study highlights the great heterogeneity among Italian epilepsy centers in current clinical practice for sleep EEG recordings. Expert consensus for sleep induction procedure is warranted.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Gloor P, Tsai C, Haddad F (1958) An assessment of the value of sleep-electroencephalography for the diagnosis of temporal lobe epilepsy. Electroencephalogr Clin Neurophysiol 10:633–648

    Article  CAS  Google Scholar 

  2. Loewy J, Hallan C, Friedman E, Martinez C (2006) Sleep/sedation in children undergoing EEG testing: a comparison of chloral hydrate and music therapy. Am J Electroneurodiagnostic Technol 46:343–355

    Article  Google Scholar 

  3. Lazic SE, Ogilvie RD (2007) Lack of efficacy of music to improve sleep: a polysomnographic and quantitative EEG analysis. Int J Psychophysiol 63:232–239

    Article  Google Scholar 

  4. Wassmer E, Fogarty M, Page A, Johnson K, Quin E, Seri S, Whitehouse W (2001) Melatonin as a sedation substitute for diagnostic procedures: MRI and EEG. Dev Med Child Neurol 43:136

    Article  CAS  Google Scholar 

  5. Johnson K, Page A, Williams H, Wassemer E, Whitehouse W (2002) The use of melatonin as an alternative to sedation in uncooperative children undergoing an MRI examination. Clin Radiol 57:502–506

    Article  CAS  Google Scholar 

  6. Sury MR, Fairweather K (2006) The effect of melatonin on sedation of children undergoing magnetic resonance imaging. Br J Anaesth 97:220–225

    Article  CAS  Google Scholar 

  7. Ashrafi MR, Mohammadi M, Tafarroji J, Shabanian R, Salamati P, Zamani GR (2010) Melatonin versus chloral hydrate for recording sleep EEG. Eur J Paediatr Neurol 14:235–238

    Article  Google Scholar 

  8. Fallah R, Yadegari Y, Behdad S, Akhavan Karbasi S (2014) Melatonin and intravenous midazolam administered orally in drug induced sleep electroencephalography of children: randomized clinical trial of efficacy. Arch Iran Med 17:741–745

    PubMed  Google Scholar 

  9. Fong CY, Tay CG, Ong LC et al (2017) Chloral hydrate as a sedating agent for neurodiagnostic procedures in children. Cochrane Database Syst Rev 11:CD011786 [Epub ahead of print]

    PubMed  Google Scholar 

  10. Ibekwe R, Jeaven L, Wilmshurst JM (2017) The role of melatonin to attain electroencephalograms in children in a sub-Saharan African setting. Seizure 51:87–94

    Article  Google Scholar 

  11. Broughton RJ (1998) SCN controlled circadian arousal and the afternoon “nap zone”. Sleep Res Online 1:166–178

    CAS  PubMed  Google Scholar 

  12. Scollo-Lavizzari G, Pralle W, Radue EW (1977) Comparative study of efficacy of waking and sleep recordings following sleep deprivation as an activation method in the diagnosis of epilepsy. Eur Neurol 15:121–123

    Article  CAS  Google Scholar 

  13. Fountain NB, Kim JS, Lee SI (1998) Sleep deprivation activates epileptiform discharges independent of the activating effects of sleep. J Clin Neurophysiol 15:69–75

    Article  CAS  Google Scholar 

  14. Kubicki S, Scheuler W, Wittenbecher H (1991) Short-term sleep EEG recordings after partial sleep deprivation as a routine procedure in order to uncover epileptic phenomena: an evaluation of 719 EEG recordings. Epilepsy Res Suppl 2:217–230

    CAS  PubMed  Google Scholar 

  15. Pohlmann-Eden B, Beghi E, Camfield C, Camfield P (2006) The first seizure and its management in adults and children. BMJ 332:339–342

    Article  Google Scholar 

  16. Xie Z, Chen F, Li WA et al (2017) A review of sleep disorders and melatonin. Neurol Res 9:559–565

    Article  Google Scholar 

  17. Jain SV, Horn PS, Simakajornboon N, Beebe DW, Holland K, Byars AW, Glauser TA (2015) Melatonin improves sleep in children with epilepsy: a randomized, double-blind, crossover study. Sleep Med 16:637–644

    Article  Google Scholar 

  18. Logothetis J (1967) Spontaneous epileptic seizures and electroencephalographic changes in the course of phenothiazine therapy. Neurology 17:869–877

    Article  CAS  Google Scholar 

  19. Aguglia U, Gambardella A, Le Piane E et al (1994) Chlorpromazine versus sleep deprivation in activation of EEG in adult-onset partial epilepsy. J Neurol 241:605–610

    Article  CAS  Google Scholar 

  20. Centorrino F, Price BH, Tuttle M, Bahk WM, Hennen J, Albert MJ, Baldessarini RJ (2002) EEG abnormalities during treatment with typical and atypical antipsychotics. Am J Psychiatry 159:109–115

    Article  Google Scholar 

  21. Ottaviano S, Giannotti F, Cortesi F (1991) The effect of niaprazine on some common sleep disorders in children. A double-blind clinical trial by means of continuous home-videorecorded sleep. Childs Nerv Syst 7:332–335

    Article  CAS  Google Scholar 

  22. Hsu DC, Cravero JP. Pharmacologic agents for pediatric procedural sedation outside of the operating room. In: UpToDate, UpToDate Inc, Wolters-Kluvers eds. Last update Dec 05, 2017

Download references

Acknowledgements

Contributors who compiled the survey and members of the Epilepsy Study Group of Italian Neurological Society, the Italian League Against Epilepsy, the Italian Pediatric Neurological Society are as follows: Irene Bagnasco, Ettore Beghi, Paolo Benna, Stefania Bergamoni, Graziella Bogliun, Mauro Budetta, Carlotta Canavese, Giuseppe Capovilla, Marco Carotenuto, Gianluca Casara, Daniela Cassano, Annalisa Colonna, Domenico Consoli, Duccio Maria Cordelli, Giuseppe D’Orsi, Anna De Benedittis, Fabrizio De Falco, Roberto De Simone, Giancarlo Di Gennaro, Elena Di Pietro, Marisa Elia, Maurizio Elia, Raffaele Falsaperla, Elisa Fiumana, Stefania Foderi, Elisabetta Gallinella, Antonio Gambardella, Paola Gambaro, Chiara Gentilomo, Anna Teresa Giallonardo, Francesco Guarino, Azzurra Guerra, Alfonso Iudice, Augusta Janes, Angela La Neve, Angelo Labate, Emilio Le Piane, Monica Lodi, Adriana Magaudda, Valentina Marchiani, Massimo Mastrangelo, Oriano Mecarelli, Stefano Meletti, Marta Meloni, Laura Mumoli, Francesco Nicita, Cristoforo Nocerino, Margherita Nosadini, Cecilia Nozzoli, Gian Andrea Ottonello, Alessandra Pagani, Maria Pandolfi, Lorenzo Pavone, Francesco Pisani, Laura Pisani, Alberto Primavera, Enrico Ravagnan, Erika Rebessi, Katia Rocchetti, Alfonso Romano, Sara Rossato, Lia Santulli, Domenico Serino, Michela Sesta, Sabrina Siliquini, Vito Sofia, Elisabetta Spadoni, Nicola Specchio, Orazio Spitaleri, Pasquale Striano, Laura Tassi, Federica Teutonico, Concetta Torrisi, Elisabetta Tozzi, Mariangela Tripodi, Marilena Vecchi, Maurizio Viri, Antonio Vitale, Roberta Vittorini, Gaetano Zaccara, and Raffaella Zannoli.

Author information

Author notes

  1. Sara Gasparini and Chiara Sueri contributed equally to this work.

Authors and Affiliations

  1. Department of Medical and Surgical Sciences, “Magna Græcia” University of Catanzaro, Viale Europa, Germaneto, Catanzaro, Italy

    Sara Gasparini, Michele Ascoli, Salvatore Maria Cavalli, Giulia Ferrigno, Umberto Aguglia & Edoardo Ferlazzo

  2. Regional Epilepsy Center, “Great Metropolitan Hospital”, Via Melacrino, Reggio Calabria, Italy

    Sara Gasparini, Chiara Sueri, Michele Ascoli, Vittoria Cianci, Salvatore Maria Cavalli, Giulia Ferrigno, Umberto Aguglia & Edoardo Ferlazzo

  3. Department of Medical and Surgical Sciences, “Sant’Anna Hospital”, Via Ravona 20, Ravona, Como, Italy

    Vincenzo Belcastro

Authors
  1. Sara Gasparini
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Chiara Sueri
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Michele Ascoli
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Vittoria Cianci
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Salvatore Maria Cavalli
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Giulia Ferrigno
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Vincenzo Belcastro
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Umberto Aguglia
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Edoardo Ferlazzo
    View author publications

    You can also search for this author in PubMed Google Scholar

Consortia

Epilepsy Study Group of the Italian Neurological Society

Corresponding author

Correspondence to Umberto Aguglia.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Gasparini, S., Sueri, C., Ascoli, M. et al. Need for a standardized technique of nap EEG recordings: results of a national online survey in Italy. Neurol Sci 39, 1911–1915 (2018). https://doi.org/10.1007/s10072-018-3525-9

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10072-018-3525-9

Keywords

Search

Navigation