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Pharmacologic Approaches to Insomnia and Other Sleep Disorders in Children

  • Pediatric Neurology (A Yeshokumar, Section Editor)
  • Published:
Current Treatment Options in Neurology Aims and scope Submit manuscript

Abstract

Purpose of Review

Sleep disorders in childhood, particularly insomnia, are very common. These disorders are almost always best addressed by behavioral interventions. Pharmacologic approaches are reserved for those children who do not respond to appropriate behavioral modification. The aim of this article is to provide an overview of the scientific basis for medications used for the childhood sleep disorders.

Recent Findings

The pharmacological treatment of insomnia and other sleep disorders is often based on extrapolation from adult data. Support for these treatments comes from case reports or small, frequently uncontrolled, pediatric studies. Finally, practitioners often rely on expert consensus to guide therapy. There is consensus that melatonin is a generally safe and effective treatment for insomnia in children. Expert consensus also indicates that iron supplementation is the first-line treatment for restless leg syndrome/periodic limb movement disorder of sleep. Tasimelteon is an FDA-approved treatment for children with Smith-Magenis syndrome who are having trouble falling asleep. Sodium oxybate and the mixed salt of oxybate containing lower sodium are approved treatments for childhood narcolepsy.

Summary

Pharmacologic treatment of childhood insomnia and other sleep disorders is generally conducted on an “off label” basis. These treatments are not considered to be first line. The use of medication in specific circumstances should be based upon the limited scientific evidence that is available.

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  1. Division of Pediatric Neurology, Department of Pediatrics, Cohen Children’s Medical Center, New York, USA

    Ivan M. Pavkovic MD & Sanjeev V. Kothare MD, FAAN, FAASM

  2. Department of Pediatrics, Zucker School of Medicine at Hofstra/Northwell, Uniondale, USA

    Ivan M. Pavkovic MD & Sanjeev V. Kothare MD, FAAN, FAASM

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Pavkovic, I.M., Kothare, S.V. Pharmacologic Approaches to Insomnia and Other Sleep Disorders in Children. Curr Treat Options Neurol 24, 129–153 (2022). https://doi.org/10.1007/s11940-022-00712-9

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