Background Melatonin has an analgesic action and interacts with different neurotransmitter systems. Nociceptive effects are the consequence of melatonin interaction with various receptors among which GABAergic receptor, opioid receptors, glutamatergic NMDA receptor (Biomedicines 2021;9:984). Moreover, melatonin can desensitize transient receptor potential vanilloid type 1 and inhibits the activities of sodium channels, including Nav1.8. Vagal fibers involved in cough express several of these ion channels and receptors. The aim of this study is to evaluate the efficacy of melatonin treatment in children with chronic somatic cough.

Methods The study population consisted of 19 children aged 9.6?17.2 years with a diagnosis of somatic chronic cough of 4-12 months duration. Participants had experienced no benefit after previously prescribed treatment with bronchodilators, oral and inhalation steroids, antitussive medications, and/or antibiotics. In 12 children chronic cough followed a mild COVID-19 disease. Before starting behavioral management and suggestion therapy, children were treated with melatonin for two consecutive days with a once-daily dosing of 1-2 mg.

Results After melatonin treatment cough resolved completely in 12 subjects and in 7 children a significant reduction of cough frequency was reported . In the latter group cough was resolved after a single suggestion therapy sitting in 6 children. Only one patient needed additional treatment and psychological counselling.

Conclusions Melatonin showed efficacy in treatment of chronic somatic cough in children. Further research are still needed to evaluate role of melatonin on the cough neural pathwaysand the benefits in chronic cough phenotypes-driven treatment.