Honey before bedtime provides greatest relief from cough

A single dose of buckwheat honey before bedtime provided the greatest relief from cough and sleep difficulty compared with no treatment and an over-the-counter cough medicine in children with upper respiratory tract infections, according to a report in the December issue of Archives of Pediatrics & Adolescent Medicine.

“Cough is the reason for nearly 3 percent of all outpatient visits in the United States, more than any other symptom, and it most commonly occurs in conjunction with an upper respiratory tract infection,” the authors write as background information in the article. Cough is usually more bothersome at night because it disrupts sleep. Although unsupported by the American Academy of Pediatrics or the American College of Chest Physicians, dextromethorphan is the most commonly used over-the-counter remedy for children's cough. “In many cultures, alternative remedies such as honey are used to treat upper respiratory tract infection symptoms including cough.”

Ian M. Paul, M.D., M.Sc., and colleagues at Penn State College of Medicine, Hershey, conducted a study involving 105 children age 2 to 18 with upper respiratory tract infections who were sick for seven days or less and experienced symptoms during the night. Thirty-five children were randomly assigned to receive an age-appropriate dose of honey, 33 to receive dextromethorphan and 37 to receive no treatment for one night within 30 minutes of bedtime. The children's parents were asked to complete a survey assessing their child's cough and sleep difficulty the night before their assigned treatment and then again the night after treatment.

Honey was found to yield the greatest improvement followed by dextromethorphan, while no treatment showed the least improvement in cough frequency, cough severity, cough bothersome to child, child's sleep and parent's sleep. “In paired comparisons, honey was significantly superior to no treatment for cough frequency and the combined score, but dextromethorphan was not better than no treatment for any outcome,” the authors write. “Comparison of honey with dextromethorphan revealed no significant differences.”

“While our findings and the absence of contemporary studies supporting the use of dextromethorphan continue to question its effectiveness for the treatment of cough associated with upper respiratory tract infections, we have now provided evidence supporting honey, which is generally regarded as safe for children older than 1 year, as an alternative,” the authors conclude. “While additional studies to confirm our findings should be encouraged, each clinician should consider the findings for honey, the absence of such published findings for dextromethorphan and the potential for adverse effects and cumulative costs associated with the use of dextromethorphan when recommending treatments for families.”

http://archpedi.ama-assn.org/