• Reference Number: HEY-794/2024
• Departments: Neurophysiology
• Last Updated: 1 January 2024

Introduction

This leaflet has been produced to give you general information about your child’s procedure. Most of your questions should be answered by this leaflet. It is not intended to replace the discussion between you and your child’s healthcare team, but may act as a starting point for discussion. If after reading it, you have any concerns or require further explanation, please discuss this with a member of the healthcare team caring for your child.

What is a Sleep EEG?

A sleep EEG will be performed by a clinical physiologist. EEG is the abbreviation of electroencephalogram, which is the recording of electrical activity produced by the brain. It can help to explain fits or seizures and is a tool to help your child’s doctor in making a diagnosis. The activity is recorded on a computer and a video recording of your child is made at the same time. Your child may be given small dose of melatonin which is a medication designed to help your child sleep. We also record for a longer period of time.

Why does my child need sleep EEG?

A sleep study is usually performed for one of three reasons:

• Following routine EEG, your child’s consultant may wish to have longer recording, including a period of sleep which may be helpful in making/confirming your child’s diagnosis.
• Your child may be too young to co-operate for routine EEG recording and doing this during sleep will be less distressing for your child.
• Occasionally, particularly if your child’s seizure/episodes is in sleep, this may be the first EEG recording your child has.

Can there be any complications or risks?

• Parents/legal guardians may be asked to sign written consent for your child to do some deep breathing or to look at flashing lights as part of the test. There is a very small chance that these procedures could provoke a seizure.
• Very occasionally, children may experience a slight local reaction at the electrode site. This may cause reddening and soreness. These symptoms resolve quickly on removal of the electrodes. If your child experiences these symptoms, please inform the staff attending to your child.

How do I prepare my child for sleep EEG?

Please read the information leaflet and share with your child if you feel this is appropriate and family (if you wish) so that they can be help and support. There may be information they need to know, especially if they are taking care of your child during/following this examination.

• If your child suffers from any allergies, please let us know as soon as possible.
• Please advise us as soon as possible if your child is taking medication to help them sleep at night.
• The night before the test, please try to deprive your child of sleep by reducing your child’s sleep by at least half (for example child’s normal regular sleep is 10 hours reduced it to 5 hours).
• If they have daytime naps, please try to discourage this.
• For 24 hours prior to the test please prevent your child drinking tea, coffee or any beverages containing caffeine (for example fizzy drinks). Apart from this please let them have a light meal.
• Please wash your child’s hair before you come to the hospital and do not use any hair products (gel, hairspray etc.)
• Give your child their medication as normal unless directed by your doctor.
• Please bring list of any current medication your child is taking.
• Please bring any favourite toy or blanket that may help your child sleep.

What will happen?

• On your arrival in the department, we will obtain your consent for the activation procedures before your child’s investigation begins.
• The clinical physiologist performing the sleep EEG will explain the test to you and will be happy to answer any questions you may have.
• Generally, we ask only one parent to accompany the child into the examination room as experience shows this makes it easier for them to fall asleep. If this is going to be a problem to you/your child, please discuss this with the clinical physiologist.
• You and your child will be asked some questions about the condition leading to their referral for EEG.
• Your child will be asked to sit on a chair and have their head measured and some points will be marked on it with a soft colour pencil.
• Your child will be given a dose of melatonin and this comes in capsule or tablet form. If your child is unable to swallow capsules/tablets, these can be dissolved in water and given as a drink in a medicine cup or via an oral syringe.
• Younger children and older children who may struggle to co-operate will be allowed to fall asleep before attempting to attach the electrodes. This can take up to an hour or more and on some occasions children do not fall asleep. If this should happen the clinical physiologist will discuss with you what would happen next.
• Several small electrodes will be placed on your child’s head using sticky paste while sat on the chair or while lying comfortably on the bed.
• Afterwards your child will be asked to close their eyes and try to fall asleep.
• The room will then be darkened to encourage sleep.
• For part of the test the clinical physiologist may ask your child to watch a flashing light although this may be unnecessary if they have recently had a routine EEG.

Use of melatonin in sleep EEG

• Your child may be given a dose of melatonin prior to recording your sleep EEG.
• Whilst melatonin is licenced in the UK in some circumstances in its prolonged released form it is not currently licensed in its immediate release form.
• The immediate release form is widely and frequently used nationally and is recognised as a safe medication for the promotion of sleep during EEG recordings.
• Further information regarding melatonin can be found in the NICE (National Institute for Health and Care Excellence) guidelines:
  • nice.org.uk (Epilepsies diagnosis and management- investigations 1.6.15) and information on unlicensed medications at www.nhs.uk (medicines information licensing).
• If you have any concerns please contact the department and ask to speak to a physiologist or ask the physiologist performing the EEG recording on the day.

What happens afterwards?

• The electrodes will be removed and your child’s head cleaned with warm water. You may wish to bring a brush or comb with you to tidy your child’s hair. Any residue of paste can be removed by shampooing the hair at home.
• You child may feel drowsy following the test due to a combination of lack of sleep and the effects of melatonin.
• Once your child has left the department the recording will be reviewed by the physiologist and then by a member of the medical team or senior physiologist who will send a report to the doctor who referred your child for the sleep EEG. This usually takes up to two weeks.

Should you require further advice on the issues contained in this leaflet, please do not hesitate to contact the Neurophysiology Department on Telephone 01482675339 or 01482675388.

General Advice and Consent

Most of your questions should have been answered by this leaflet, but remember that this is only a starting point for discussion with the healthcare team.

Consent to treatment

Before any doctor, nurse or therapist examines or treats your child, they must seek your consent or permission. In order to make a decision, you need to have information from health professionals about the treatment or investigation which is being offered to your child. You should always ask them more questions if you do not understand or if you want more information.

The information you receive should be about your child’s condition, the alternatives available for your child, and whether it carries risks as well as the benefits. What is important is that your consent is genuine or valid. That means:

• you must be able to give your consent
• you must be given enough information to enable you to make a decision
• you must be acting under your own free will and not under the strong influence of another person

Information about your child

We collect and use your child’s information to provide your child with care and treatment. As part of your child’s care, information about your child will be shared between members of a healthcare team, some of whom you may not meet. Your child’s information may also be used to help train staff, to check the quality of our care, to manage and plan the health service, and to help with research. Wherever possible we use anonymous data.

We may pass on relevant information to other health organisations that provide your child with care. All information is treated as strictly confidential and is not given to anyone who does not need it. If you have any concerns please ask your child’s doctor, or the person caring for your child.

Under the General Data Protection Regulation and the Data Protection Act 2018 we are responsible for maintaining the confidentiality of any information we hold about your child. For further information visit the following page: Confidential Information about You.

If you need information about your child’s (or a child you care for) health and wellbeing and their care and treatment in a different format, such as large print, braille or audio, due to disability, impairment or sensory loss, please advise a member of staff and this can be arranged.