Melatonin to Induce Natural Sleep During Multiple-Breath Washout in Infants and Toddlers With Cystic Fibrosis
Nathalie Jouret1,2, Stijn Verhulst1,2, Kim Van Hoorenbeeck1,2
1Department of Pediatric Pulmonology, Antwerp University Hospital, Edegem, Belgium.
Introduction:
Pulmonary function testing is an important clinical tool to monitor cystic fibrosis (CF) lung disease. Compared to conventional spirometry, multiple-breath washout (MBW) requires minimal co-operation. However, steady tidal breathing can be quite challenging in infants and toddlers, and can only be successfully achieved during sleep, often requiring sedation. We aimed to evaluate the use of melatonin to perform MBW investigations during natural sleep in young children with CF.
Materials And Methods:
MBW investigations during sleep by the use of melatonin were scheduled together with routine visits for infants and toddlers at the pediatric CF clinic of the Antwerp University Hospital, Belgium.
Results:
From May 2024 to March 2025, seven children with CF, aged 3-33 months, received melatonin to perform MBW. Sleep was achieved in all patients after a final dose of 10 mg of melatonin with a relatively short median full test duration of 87 min. Five MBW investigations were successfully accomplished.
Conclusion:
Melatonin can be used to perform MBW during sleep in infants and toddlers with CF. Inducing natural sleep makes melatonin a safe, feasible, and less time-consuming alternative compared to sedatives. Future MBW investigations using melatonin are warranted to confirm these findings.
Related Concept Videos
Management of Insomnia
Sleep-Wake Cycles
NREM Sleep
NREM sleep comprises four progressive stages that seamlessly merge:
Sedatives and Hypnotics Drugs: Miscellaneous Agents
Melatonin congeners like ramelteon (Rozerem) and tasimelteon (Hetlioz) selectively bind to melatonin receptors (MT1 and MT2) and thus mimic the actions of melatonin, a hormone that regulates sleep-wake cycles. Tasimelteon is primarily used for non-24-hour sleep-wake disorder, common in blind patients. They are also used to treat conditions like insomnia...
Cystic Fibrosis: Management
Sinus disease and chronic sinusitis...
Understanding Sleep
The circadian rhythm, a nearly 24-hour cycle, is deeply influenced by environmental light cues. Light exposure directly affects the hypothalamus, which in turn regulates...
Upper Respiratory Drugs: Antitussives, Expectorants, and Mucolytics
Antitussives include codeine, dextromethorphan (Robitussin), and benzonatate (Tessalon). Codeine and dextromethorphan exert their effects centrally by suppressing the cough reflex center in the medulla. Benzonatate operates peripherally within the respiratory tract by anesthetizing...

