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Volume :
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01
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Issue :
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01
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Pages :
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49-59
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None
The Use of Pharmacotherapy in the Treatment of Pediatric Insomnia in Primary Care: Rational Approaches. A Consensus Meeting Summary
Judith A. Owens M.D., M.P.H.1; Deborah Babcock, M.D.2; Jeffrey Blumer, M.D.3; Ronald Chervin, M.D.4; Richard Ferber, M.D.5; Mark Goetting, M.D.6; Daniel Glaze, M.D.7; Anna Ivanenko, M.D.8; Jodi Mindell, Ph.D9; Marsha Rappley, M.D.10; Carol Rosen, M.D.3; Stephen Sheldon, D.O.11
1Brown Medical School and Hasbro Children’s Hospital, Providence, RI; 2Altos Pediatric Associates, Los Altos, CA; 3 Case School of Medicine and Rainbow Babies and Children’s Hospital, Cleveland, OH; 4University of Michigan Medical School, Ann Arbor, MI; 5Harvard Medical School, Boston, MA; 6Kalamazoo Neurology, Kalamazoo, MI; 7Baylor College of Medicine, Houston, TX; 8Loyola University Medical Center, Maywood, IL; 9St. Joseph’s University and Children’s Hospital of Philadelphia, Philadelphia, PA; 10Michigan State University Medical School, East Lansing, MI and American Academy of Pediatrics, Elk Grove Village, IL; 11Northwestern University, Feinberg School of Medicine, Chicago, IL
Objectives:
To formulate a rational approach to the pharmacologic treatment of pediatric insomnia, and to develop clinical guidelines regarding indications, target populations, and parameters for the use of these medications, especially by community-based pediatricians.
Participants:
A multidisciplinary task force developed under the auspices of the American Academyof Sleep Medicine, which included experts in pediatric sleep medicine, psychiatry, pharmacology, neurology, and general pediatrics.
Evidence:
Review of existing data regarding current use of over-the-counter and prescription medications for pediatric insomnia in the primary care practice setting, and of empirical data on the pharmacology, safety, efficacy, and tolerability of medications commonly used for the treatment of pediatric insomnia
Consensus Process:
Group consensus definition of pediatric insomnia and clinical guidelines; working group recommendations regarding special populations and future directions.
Conclusions:
Use of medications for pediatric insomnia should be diagnostically driven, and should be implemented in conjunction with empirically-based behavioral treatment strategies and adequate sleep hygiene. Specific target populations include children with neurodevelopmental disorders, pervasive developmental disorders, chronic medical conditions, and psychiatric disorders. Additional research, including clinical trials, is critically needed to provide an evidence-based approach to the use of these medications in clinical practice.