The treatment of sleep disorde

A 9-year-old girl is brought to clinic by anxious parents, who say she suffers sleeplessness and night waking. This situation has persisted for the last six months. There are no significant changes coinciding with the onset of her disturbed sleeping pattern.

Her parents have tried the behavioural changes suggested by the health advisor for three months with no success. They now seek a pharmacological intervention.

A diagnosis of primary insomnia is made. While parents agree to try the behavioural changes suggested by the doctor, they are disappointed that there is no pharmacological intervention offered.

In children with sleeping disorders, is there a role for pharmacological interventions in improving sleeping patterns?

Cochrane: ¡§sleep disorder¡¨ , ¡§children¡¨.

Pubmed ¡§sleep disorder¡¨ , ¡§children¡¨ , ¡§treatment¡¨.

Clinical evidence: ¡§sleep disorder¡¨.

Insomnia is a disturbance of normal sleep patterns characterised by difficulty in initiating sleep and/or difficulty maintaining sleep, with frequent nocturnal or early morning awakenings.

Although children¡¦s sleep disorders are comm

„h More than 75% of practitioners had recommended non-prescription medications. Antihistamines were the most commonly reported non-prescription medications for sleep. Melatonin or herbal remedies had been recommended by approximately 15% of the respondents

Use of hypnotics considerably by geographic area. Kopferschmitt et al, reported that some 12% of 11 595 kindergarten children in France had been given psychotropic medication for "sleep problems" for 6 months to 5 years. In contrast, medication is rarely given in the US; practitioners prefer behavioural approaches.

Despite the significance of the problem there exists little guidance for clinicians on how to medicate sleep disorder in children.

„h Newer hypnotics e.g. Zalovudine appear promising.

Some topics in this essay:
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