0
0

Chapter 51. Medications Used for Sleep

Kyle P. Johnson, M.D.; Anna Ivanenko, M.D., Ph.D.
DOI: 10.1176/appi.books.9781585623921.475212

Sections

Excerpt

Prescription and nonprescription medications are being used for sleep problems by child psychiatrists and pediatricians at increasing rates, despite there being no U.S. Food and Drug Administration (FDA)–approved drugs for pediatric insomnia. We are beginning to see, only recently, published research on pharmacotherapy for pediatric sleep disorders. This chapter will summarize the use of medications for sleep disorders in children and adolescents. A recent survey of child and adolescent psychiatrists reveals that prescription or nonprescription medications are frequently used to manage insomnia in the following disorders: primary insomnia, depression, bipolar affective disorder, anxiety, posttraumatic stress disorder, delayed sleep phase syndrome, attention-deficit/hyperactivity disorder (ADHD), autism spectrum disorder, chronic pain, oppositional disorder, and mental retardation/developmental delay (Rosen et al. 2005). More than 75% of primary care pediatricians surveyed recommended nonprescription medications for pediatric insomnia and greater than 50% had prescribed a medication specifically for sleep (Owens et al. 2003). Clinical situations in which medications were most commonly used were acute pain and travel, closely followed by children with special needs such as mental retardation, autism, and ADHD.

Your session has timed out. Please sign back in to continue.
Sign In Your Session has timed out. Please sign back in to continue.
Sign In to Access Full Content
 
Username
Password
Sign in via Athens (What is this?)
Athens is a service for single sign-on which enables access to all of an institution's subscriptions on- or off-site.
Not a subscriber?

Subscribe Now/Learn More

PsychiatryOnline subscription options offer access to the DSM-5 library, books, journals, CME, and patient resources. This all-in-one virtual library provides psychiatrists and mental health professionals with key resources for diagnosis, treatment, research, and professional development.

Need more help? PsychiatryOnline Customer Service may be reached by emailing PsychiatryOnline@psych.org or by calling 800-368-5777 (in the U.S.) or 703-907-7322 (outside the U.S.).

Table Reference Number
TABLE 51–1. Pharmacological characteristics of benzodiazepines
Table Reference Number
TABLE 51–2. Nonbenzodiazepine benzodiazepine receptor agonists

References

Clark A: Incidences of new prescribing by British child and adolescent psychiatrists: a prospective study over 12 months. J Psychopharmacol 18:115–120, 2004
[PubMed]
 
Garcia-Borreguero D, Lorrosa O, de la Llave Y, et al: Treatment of restless legs syndrome with gabapentin: a double-blind, cross-over study. Neurology 59:1573–1579, 2002
[PubMed]
 
Garstang J, Wallis M: Randomized controlled trial of melatonin for children with autistic spectrum disorders and sleep problems. Child Care Health Dev 32:585–589, 2006
[PubMed]
 
Greenhill LL, Biederman J, Boellner SW, et al: A randomized, double-blind, placebo-controlled study of modafinil film-coated tablets in children and adolescents with attention-deficit/hyperactivity disorder. J Am Acad Child Adolesc Psychiatry 45:503–511, 2006
[PubMed]
 
Ingrassia A, Turk J: The use of clonidine for severe and intractable sleep problems in children with neurodevelopmental disorders: a case series. Eur Child Adolesc Psychiatry 14:34–40, 2005
[PubMed]
 
Ivanenko A, Tauman R, Gozal D: Modafinil in the treatment of excessive daytime sleepiness in children. Sleep Med 4:579–582, 2003
[PubMed]
 
Jan JE, Freeman RD: Melatonin therapy for circadian rhythm sleep disorders in children with multiple disabilities: what have we learned in the last decade? Dev Med Child Neurol 46:776–782, 2004
[PubMed]
 
Jan JE, Wasdell MB, Reiter RJ, et al: Melatonin therapy of pediatric sleep disorders: recent advances, why it works, who are the candidates and how to treat. Curr Pediatr Rev 3:214–224, 2007
 
Konafal E, Arnulf I, Lecendreux M, et al: Ropinirole in a child with attention-deficit hyperactivity disorder and restless legs syndrome. Pediatr Neurol 32:350–351, 2005
 
Lewy AJ, Emens JS, Lefler BJ, et al: Melatonin entrains free-running blind people according to a physiological dose-response curve. Chronobiol Int 22:1093–1106, 2005
[PubMed]
 
Lin JS, Hou Y, Jouvet M: Potential brain neuronal targets for amphetamine-, methylphenidate-, and modafinil-induced wakefulness, evidenced by c-fos immunochemistry in the cat. Proc Natl Acad Sci USA 93:14128–14133, 1996
[PubMed]
 
Martinez S, Guilleminault C: Periodic leg movements in prepubertal children with sleep disturbance. Dev Med Child Neurol 46:765–770, 2004
[PubMed]
 
Mindell JA, Emslie G, Blumer J, et al: Pharmacologic management of insomnia in children and adolescents: consensus statement. Pediatrics 117:e1223–e1232, 2006
 
Murali H, Kotagal S: Off-label treatment of severe childhood narcolepsy-cataplexy with sodium oxybate. Sleep 29:1025–1029, 2006
[PubMed]
 
Owens J, Rosen CL, Mindell JA: Medication use in the treatment of pediatric insomnia: results of a survey of community-based pediatricians. Pediatrics 111:e628–e635, 2003
 
Prince JB, Wilens TE, Biederman J, et al: Clonidine for sleep disturbances associated with attention-deficit hyperactivity disorder: a systematic chart review of 62 cases. J Am Acad Child Adolesc Psychiatry 35:599–605, 1996
[PubMed]
 
Rosen CL, Owens JA, Mindell JA, et al: Use of pharmacotherapy for insomnia in children and adolescents: a national survey of child psychiatrists (abstract). Sleep 28(suppl):A79, 2005
 
Scammell TE, Estabrooke IV, McCarthy MT, et al: Hypothalamic arousal regions are activated during modafinil-induced wakefulness. J Neurosci 20:8620–8628, 2000
[PubMed]
 
Smits MG, Nagtegaal EE, van der Heijden J, et al: Melatonin for chronic sleep onset insomnia in children: a randomized placebo-controlled trial. J Child Neurol 16:86–92, 2001
[PubMed]
 
Smits MG, van Stel HF, van der Heijden K, et al: Melatonin improves health status and sleep in children with idiopathic chronic sleep-onset insomnia: a randomized placebo-controlled trial. J Am Acad Child Adolesc Psychiatry 42:1286–1293, 2003
[PubMed]
 
Szeinberg A, Borodkin K, Dagan Y: Melatonin treatment in adolescents with delayed sleep phase syndrome. Clin Pediatr 45:809–818, 2006
[PubMed]
 
U.S. Modafinil in Narcolepsy Multicenter Study Group: Randomized trial of modafinil as a treatment for the excessive daytime somnolence of narcolepsy. Neurology 54:1166–1175, 2000
 
Walters AS, Mandelbaum DE, Lewin DS, et al: Dopaminergic therapy in children with restless legs/periodic limb movements in sleep and ADHD. Pediatr Neurol 22:182–186, 2000
[PubMed]
 
Weiss MD, Wasdell MB, Bomben MM, et al: Sleep hygiene and melatonin treatment for children and adolescents with ADHD and initial insomnia. J Am Acad Child Adolesc Psychiatry 45:512–519, 2006
[PubMed]
 
Wilens TE, Biederman J, Spencer T: Clonidine for sleep disturbances associated with attention-deficit hyperactivity disorder. J Am Acad Child Adolesc Psychiatry 33:424–426, 1994
[PubMed]
 
+

CME Activity

Add a subscription to complete this activity and earn CME credit.
Sample questions:
1.
Which of the following neurotransmitters is responsible for the regulation of sleep?
2.
Medications exert their sedative effect through different mechanisms, affecting different receptors. All of the following medications are correctly paired with their receptors/mechanisms except
3.
Which of the following statements regarding melatonin is false?
NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).
Related Content
Articles
Books
The American Psychiatric Publishing Textbook of Psychiatry, 5th Edition > Chapter 22.  >
The American Psychiatric Publishing Textbook of Psychiatry, 5th Edition > Chapter 36.  >
Gabbard's Treatments of Psychiatric Disorders, 4th Edition > Chapter 1.  >
Gabbard's Treatments of Psychiatric Disorders, 4th Edition > Chapter 2.  >
Gabbard's Treatments of Psychiatric Disorders, 4th Edition > Chapter 3.  >
Topic Collections
Psychiatric News
PubMed Articles
 
  • Print
  • PDF
  • E-mail
  • Chapter Alerts
  • Get Citation