Forty-five children (mean age, 7.3 years; range, 3.2-10.6 years) experiencing a mean of 6.6 sleep terror episodes per month were randomly assigned to receive L-5-hydroxytryptophan (5-HTP) (n = 31) or to serve as an untreated control group (n = 14). The dose of 5-HTP was 2 mg/kg of body weight at bedtime for 20 days. At the one-month follow-up visit, the sleep terrors had completely disappeared in 51.6% of the children receiving 5-HTP, and there was a greater-than-50% reduction in an additional 41.9% of cases, for a positive response rate of 93.5%. In the control group, the episodes disappeared in 28.6%, while 71.4% showed no change. After 6 months, 83.9% of children treated with 5-HTP and 28.6% of controls were free of sleep terrors.

Comment: Sleep terrors are characterized by sudden waking from slow wave sleep with persistent fear or terror, screaming, sweating, confusion, and increased heart rate. People with sleep terrors usually do not report dreams or nightmares, but might have a vague sense of frightening images. The prevalence of sleep terrors ranges from 1% to 7.5%, with peak prevalence between ages 5 and 7 years. It has been suggested that sleep terrors are associated with a dysfunction of the serotonergic system. The results of the present study suggest that short-term treatment with 5HTP (the precursor to serotonin) results in a long-term improvement in sleep terrors.

Bruni O, et al. L-5-Hydroxytryptophan treatment of sleep terrors in children. Eur J Pediatr 2004;163:402-407.