Medication use in the treatment of pediatric insomnia: results of a survey of community-based pediatricians.

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http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12728122&dopt=Abstract

 
Pediatrics. 2003 May;111(5 Pt 1):e628-35. Related Articles, Links
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Medication use in the treatment of pediatric insomnia: results of a survey of community-based pediatricians.

Owens JA, Rosen CL, Mindell JA.

Department of Pediatrics and Division of Ambulatory Pediatrics, Brown Medical School, Providence, Rhode Island, USA. Owensleep@aol.com

OBJECTIVES: To examine clinical practice patterns, beliefs, and attitudes regarding the use of both nonprescription and prescription medications by community-based pediatricians for children with significant difficulties in initiating and/or maintaining sleep. METHODS: A survey was mailed to 3424 American Academy of Pediatrics members in 6 US cities. RESULTS: The final sample (n = 671) consisted of practitioners who identified themselves as primary care pediatricians. Three percent +/- 7% of visits in the respondents' practices were for pediatric insomnia, although there was a wide range in the numbers of children identified during a typical 6-month practice period. More than 75% of practitioners had recommended nonprescription medications, and >50% had prescribed a sleep medication. Specific clinical circumstances in which medications were most commonly used were acute pain and travel, followed by children with special needs (mental retardation, autism, and attention-deficit/hyperactivity disorder). Antihistamines were the most commonly reported nonprescription medications for sleep. Melatonin or herbal remedies had been recommended by approximately 15% of the respondents. alpha-agonists were the most frequently prescribed sleep medications (31%). The likelihood of prescribing medication for sleep was 2- to 4-fold greater in respondents who treated children with attention-deficit/hyperactivity disorder for daytime behavioral problems or nocturnal sleep problems, respectively. Practitioners expressed a range of concerns about sleep medication appropriateness, safety, tolerance, and side effects in children. CONCLUSIONS: The practice of prescribing or recommending sedatives and hypnotics for pediatric insomnia is common among community-based pediatricians, especially among special needs patients. An empirically based approach to the use of these medications is needed.

Publication Types:
  • Multicenter Study


PMID: 12728122 [PubMed - indexed for MEDLINE]

 

 

 

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