Objectives: To compare the effects of a single nocturnal dose of buckwheat honey or honey-flavored dextromethorphan (DM) with no treatment on nocturnal cough and sleep difficulty associated with childhood upper respiratory tract infections.

Design: A survey was administered to parents on 2 consecutive days, first on the day of presentation when no medication had been given the prior evening and then the next day when honey, honey-flavored DM, or no treatment had been given prior to bedtime according to a partially double-blinded randomization scheme.

Setting: A single, outpatient, general pediatric practice.

Participants: One hundred five children aged 2 to 18 years with upper respiratory tract infections, nocturnal symptoms, and illness duration of 7 days or less.

Intervention: A single dose of buckwheat honey, honey-flavored DM, or no treatment administered 30 minutes prior to bedtime.

Main outcome measures: Cough frequency, cough severity, bothersome nature of cough, and child and parent sleep quality.

Results: Significant differences in symptom improvement were detected between treatment groups, with honey consistently scoring the best and no treatment scoring the worst. In paired comparisons, honey was significantly superior to no treatment for cough frequency and the combined score, but DM was not better than no treatment for any outcome. Comparison of honey with DM revealed no significant differences.

Conclusions: In a comparison of honey, DM, and no treatment, parents rated honey most favorably for symptomatic relief of their child’s nocturnal cough and sleep difficulty due to upper respiratory tract infection. Honey may be a preferable treatment for the cough and sleep difficulty associated with childhood upper respiratory tract infection.

Trial registration: clinicaltrials.gov Identifier: NCT00127686.