TY - JOUR
T1 - The trial of infant response to diphenhydramine
T2 - The TIRED study - A randomized, controlled, patient-oriented trial
AU - Merenstein, Dan
AU - Diener-West, Marie
AU - Halbower, Ann C.
AU - Krist, Alex
AU - Rubin, Haya R.
N1 - Copyright:
Copyright 2010 Elsevier B.V., All rights reserved.
PY - 2006
Y1 - 2006
N2 - Objective: To determine if infants aged 6 to 15 months with frequent parent-reported nighttime awakenings require reduced parental aid during a week of diphenhydramine hydrochloride treatment and 2 and 4 weeks after its discontinuation. Design: Double-blind, randomized, controlled clinical trial. Setting: The study was conducted from May 1, 2004, through May 1, 2005; patients were recruited nationally. Participants: Forty-four participants aged 6 to 15 months. Interventions: Placebo or diphenhydramine was administered in infants 30 minutes before anticipated bedtime. Main Outcome Measures: The primary outcome was dichotomous: a parental report of improvement in the number of night awakenings requiring parental assistance during the intervention week, which ended on day 14. Secondary outcomes were improved sleep during the 2 weeks before days 29 and 43, parental overall happiness with sleep, and improved sleep latency. Results: On June 6, 2005, the data safety monitoring board voted unanimously to stop the trial early because of lack of effectiveness of diphenhydramine over placebo. Only 1 of 22 children receiving diphenhydramine showed improvement compared with 3 of 22 receiving placebo. To reach the a priori determined sample size and have a positive outcome (ie, rejecting the null hypothesis), the trial would have needed to enroll 16 more participants in each arm, with 15 of the 16 in the diphenhydramine group and 0 of 16 in the placebo group improving. Conclusion: During 1 week of therapy and at follow-up 2 and 4 weeks later, diphenhydramine was no more effective than placebo in reducing nighttime awakening or improving overall parental happiness with sleep for infants.
AB - Objective: To determine if infants aged 6 to 15 months with frequent parent-reported nighttime awakenings require reduced parental aid during a week of diphenhydramine hydrochloride treatment and 2 and 4 weeks after its discontinuation. Design: Double-blind, randomized, controlled clinical trial. Setting: The study was conducted from May 1, 2004, through May 1, 2005; patients were recruited nationally. Participants: Forty-four participants aged 6 to 15 months. Interventions: Placebo or diphenhydramine was administered in infants 30 minutes before anticipated bedtime. Main Outcome Measures: The primary outcome was dichotomous: a parental report of improvement in the number of night awakenings requiring parental assistance during the intervention week, which ended on day 14. Secondary outcomes were improved sleep during the 2 weeks before days 29 and 43, parental overall happiness with sleep, and improved sleep latency. Results: On June 6, 2005, the data safety monitoring board voted unanimously to stop the trial early because of lack of effectiveness of diphenhydramine over placebo. Only 1 of 22 children receiving diphenhydramine showed improvement compared with 3 of 22 receiving placebo. To reach the a priori determined sample size and have a positive outcome (ie, rejecting the null hypothesis), the trial would have needed to enroll 16 more participants in each arm, with 15 of the 16 in the diphenhydramine group and 0 of 16 in the placebo group improving. Conclusion: During 1 week of therapy and at follow-up 2 and 4 weeks later, diphenhydramine was no more effective than placebo in reducing nighttime awakening or improving overall parental happiness with sleep for infants.
UR - http://www.scopus.com/inward/record.url?scp=33745728094&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=33745728094&partnerID=8YFLogxK
U2 - 10.1001/archpedi.160.7.707
DO - 10.1001/archpedi.160.7.707
M3 - Article
C2 - 16818836
AN - SCOPUS:33745728094
SN - 1072-4710
VL - 160
SP - 707
EP - 712
JO - Archives of Pediatrics and Adolescent Medicine
JF - Archives of Pediatrics and Adolescent Medicine
IS - 7
ER -