Comparison of sedative drugs (chloral hydrate, hydroxyzine, and melatonin) and natural sleep used in sleep transition before electroencephalogram exposure in children: A randomized controlled trial

Abstract

Objectives: This study aimed to evaluate the effects of sedative drugs and natural sleep on sleep success, duration of falling asleep, and the baseline for electroencephalogram (EEG) recording in children, as well as adverse effects.

Patients and methods: This single-blind, randomized controlled clinical study was conducted with 180 children (113 males, 67 females; mean age: 41.66 ± 25.34 months; range, 1 to 7 years) between January and December 2021. The study comprised two stages: Stage I, preliminary preparation, and Stage II, procedure preparation and EEG recording.

Results: The sedative drug groups had a significant difference in the duration of falling asleep (p < 0.001). The duration was the shortest in the chloral hydrate group, and it was the longest in the natural sleep group. Excessive fast act patterns were highest in the chloral hydrate group and significantly lower in the natural sleep group (p = 0.042). While frequency values differed significantly among the groups, the frequency value in the hydroxyzine group was significantly higher than that in the melatonin group (p = 0.001).

Conclusion: In conclusion, while our study provided clear evidence that melatonin offered a safer sedation alternative with minimal EEG interference, the challenge of developing universally applicable sedation protocols remains. Future research should focus on multicenter trials, innovative sedative combinations, and integrating technological advances to improve both the safety and diagnostic accuracy of pediatric EEG.

Cite this article as: Tutar Ş, Kutluk MG. Comparison of sedative drugs (chloral hydrate, hydroxyzine, and melatonin) and natural sleep used in sleep transition before electroencephalogram exposure in children: A randomized controlled trial. Turk J Neurol 2026;32(1):37-49. https://doi.org/10.55697/tnd.2026.197.

The data that support the findings of this study are available from the corresponding author upon reasonable request.

Ş.T., M.G.K.: Study conception and design, analysis and interpretation of results, draft manuscript preparation; Ş.T.: Data collection. All authors reviewed the results and approved the final version of the manuscript.

The authors declared no conflicts of interest with respect to the authorship and/or publication of this article.

The authors received no financial support for the research and/or authorship of this article.

The authors declare that artificial intelligence (AI) tools were not used, or were used solely for language editing, and had no role in data analysis, interpretation, or the formulation of conclusions. All scientific content, data interpretation, and conclusions are the sole responsibility of the authors. The authors further confirm that AI tools were not used to generate, fabricate, or ‘hallucinate’ references, and that all references have been carefully verified for accuracy.

We thank all the children and their parents who participated in the study.