Hypnotic effects of ramelteon during electroencephalography

The efficacy of ramelteon, a sleep agent thought to induce natural sleep through its actions on the melatonin receptors 1 and 2, was evaluated during electroencephalography (EEG).We retrospectively analyzed the data from 862 EEG sessions in the electronic medical records of 523 patients (mean age, 8.9 ± 6.4 years; range, 0-38 years) who underwent EEGs in the Department of Pediatrics of Kawasaki Medical School Hospital. We compared the sleep induction statuses of patients not treated with hypnotics and those treated with the following hypnotics: ramelteon, triclofos sodium, and/or chloral hydrate.The success rates of sleep induction in the different groups were as follows: 440/513 (85.7%) in the hypnotic-free, 60/63 (95.2%) in the ramelteon, 209/217 (96.3%) in the triclofos sodium, 36/37 (97.3%) in the chloral hydrate, and 29/32 (90.6%) in the triclofos sodium plus chloral hydrate group. The incidence of adverse reactions was 0/63 (0%) in the ramelteon, 104/199 (52.2%) in the triclofos sodium, 12/31 (38.7%) in the chloral hydrate, and 20/30 (66.7%) in the triclofos sodium plus chloral hydrate group. The mean sleep latency in the ramelteon group was 22.3 ± 12.8 min (range, 5-60 min).Ramelteon induced sleep significantly more compared to the control group. The incidence of adverse reactions after treatment with ramelteon was significantly lower than after treatment with any of the other hypnotics. These results suggest that ramelteon is useful as a hypnotic during EEG.