Study of the efficacy of melatonin for auditory brainstem response (ABR) testing in children.

STUDY OBJECTIVE: To evaluate the efficacy of oral melatonin to induce sedation (natural sleep) while measuring auditory brainstem responses (ABR) in children with suspected hearing loss by calculating the ABR success rate with the use of melatonin, the percentage of children in whom sleep was induced by melatonin and the time required to perform complete ABR testing.

MATERIAL AND METHODS: Twenty-nine children aged 1 to 6 years were included in this prospective study. ABR testing was performed as a day-case procedure in a single room ensuring suitable sleeping conditions. Five milligrams of melatonin (or 10mg in children over the age of 6 years) were administered orally before electrode positioning. An additional 5 milligrams were administered if the child failed to sleep after 30minutes.

RESULTS: ABR was performed with melatonin in 58 ears: complete ABR testing was performed in both ears in 19 children (65%), corresponding to 38 examinations; only one ear was tested in 7 children (24.2%), corresponding to 7 examinations; and ABR testing could not be performed in 3 children (10.3% failure rate). Good quality sleep was obtained in 17 children (59%), brief sleep was obtained in 4 children (14%), who nevertheless remained calm throughout the examination and 8 children (27%) did not fall asleep. The mean sleep-onset time after administration of melatonin was 41minutes with a mean sleep time of 33minutes and a mean examination time of 52minutes after the first dose of melatonin. A complete examination therefore took an average of 93minutes.

CONCLUSION: The use of melatonin allowed partial or complete ABR testing in 90% of children. This method is effective, but it requires adapted facilities to receive the child and the child's parents.