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Drugs which affect Sleep

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Pediatric Sleep Medicine

Abstract

This chapter summarizes the current knowledge about the impact of pharmacotherapy on sleep and sleep disorders in the pediatric population. Poor sleep quality and/or quantity in children, especially in the presence of sleep disorders, is associated with deficits in neurodevelopment, cognition, and behavior. However, clear guidelines regarding pediatric sleep pharmacotherapy are lacking.

The only approved drug by Food and Drug Administration (FDA) for the management of sleep–wake disorders in children is sodium oxybate for narcolepsy. Other common pediatric sleep disorders are often treated in an empiric way, because of lack of evidence-based guidelines and officially approved pediatric sleep pharmacotherapy. For example, clonidine is used for the management of pediatric insomnia, whereas beta-blockers are used for the management of the abnormal circadian pattern seen in children with Smith–Magenis syndrome.

Moreover, several medical therapies can also influence sleep quality or quantity in pediatric population. For example, children receiving dexamethasone sleep longer than usual, with more daytime naps and less awakening. Other therapies can predispose toward sleep disorders in children. For example, increased risk of narcolepsy was observed following vaccination with a monovalent 2009 H1N1 influenza vaccine, which was used in several European countries during the H1N1 influenza pandemic.

Finally, there is an overall lack of training in pediatric sleep medicine worldwide. This fact can lead to disinclination to pharmacotherapy or improper prescription of drugs or inability to recognize the side effects of other therapies on sleep–wake cycle.

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Abbreviations

ADHD:

Attention deficit hyperactivity disorder

AHI:

Apnea–hypopnea index

CNSS:

Central nervous system stimulant

CRSWD:

Circadian rhythm sleep–wake disorder

FDA:

Food and Drug Administration

NREM:

Non-rapid eye movement

OSA:

Obstructive sleep apnea

PLMD:

Periodic limb movement disorder

REM:

Rapid eye movement

RLS:

Restless legs syndrome

SM:

Smith–Magenis syndrome

SSRI:

Selective serotonin reuptake inhibitors

SWD:

Sleep–wake disorder

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Economou, NT., Papoutsis, K., Ferini-Strambi, L., Trakada, G. (2021). Drugs which affect Sleep. In: Gozal, D., Kheirandish-Gozal, L. (eds) Pediatric Sleep Medicine. Springer, Cham. https://doi.org/10.1007/978-3-030-65574-7_24

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