• Home
  • Store
    • Newsletter Subscriptions
    • Multimedia Subscriptions
    • Books
    • eBooks
    • ABPN SA Courses
  • CME Center
  • Multimedia
    • Podcast
    • Webinars
    • Blog
  • Newsletters
    • General Psychiatry
    • Child Psychiatry
    • Addiction Treatment
    • Hospital Psychiatry
    • Geriatric Psychiatry
  • Log In
  • Register
  • Welcome
  • Sign Out
  • Subscribe
Home » Trends in Medication Use for Children with Insomnia

Trends in Medication Use for Children with Insomnia

September 1, 2010
From The Carlat Child Psychiatry Report
Issue Links: Learning Objectives | Editorial Information
Caroline Fisher, PhD, MD. 

Subject:
INSOMNIA

Short Description:
Trends in Medication Use for Children with Insomnia

Background:
Children with psychiatric disorders often present with insomnia in addition to their primary symptoms. How should we treat insomnia in children? Every clinician seems to have his or her favorite go-to hypnotic. In an effort to determine which hypnotics American child psychiatrists favor, a group of researchers surveyed members of the American Academy of Child and Adolescent Psychiatry. A modified version of the Pediatric Drug Survey instrument (created by researchers to study prescribing practices among pediatricians) was mailed to 6,018 child psychiatrists; 1,273 responded. The questionnaire was designed to collect data on four areas: 1) prevalence of problem insomnia among patients; 2) medication strategies for managing insomnia in four different clinical groups: mental retardation/developmental delay (MD/DD) or autism, ADHD, anxiety disorder (AD), or mood disorder (MD); 3) reasons for and against using medication to treat insomnia; and 4) demographic information about the respondents (ie, age, gender, academic affiliation). In this study, insomnia was defined as bedtime resistance, and/or significant difficulty falling and/or staying asleep. The average psychiatrists said that over a typical one month period, they treat 28% of their pediatric patients with some type of insomnia medication. They were most likely to treat insomnia in older patients (32% of patients ages 13 to 18) and least likely to treat their youngest patients (3.5% of those under two years old). Psychiatrists’ choice of medication varied based on the comorbid psychiatric condition. For patients with insomnia associated with ADHD, alpha agonists (such as clonidine) were the most popular medications, prescribed by 81% of psychiatrists surveyed. For insomnia in anxiety, mood, and developmental disorders, trazodone and sedating antidepressants were by far the most popular, prescribed by 65 to 85% of psychiatrists, depending on the disorder. Here is the overall total percentage of psychiatrists who reported prescribing each medications group: Alpha agonists, 87%; trazodone, 85.8%; sedating antidepressants, 83.2%; atypical antipsychotics, 68.9%; SSRIs, 66.6%; benzodiazapines, 54.5%; short acting hypnotics, 50.2%; anticonvulsants, 49.1%; and tricyclics, 48.3%. Regarding over-the-counter medications, antihistamines such as Benadryl were commonly recommended for all disorders (used by nearly 70% of psychiatrists) followed by melatonin, which was a distant second (about 40%). Interestingly, physicians who had the most years in practice were the least likely to report prescribing medication to treat insomnia in most cases, as were those with academic appointments at medical schools. Whether this reflects the wisdom to know when not to prescribe, or, alternatively, a refusal to keep up with new trends is not addressed by the study (Owens JA et al., Sleep Med 2010; online ahead of print).

TCPR's Take:
The study was funded by Sanofi Aventis, the makers of Ambien and Ambien CR, and some apparent commercial bias came through in the discussion section, in which the researchers expressed dismay that so much trazodone is being prescribed and that non-benzodiazepines are relatively underprescribed. Nonetheless, this data is useful, if only to show us what the current standard of pediatric insomnia treatment seems to be. When considering prescribing sleep aids to children and adolescents with insomnia, we should remember to ask about computer and television use and consumption of sugary soft drinks or energy drinks, all of which can affect sleep.

Child Psychiatry
www.thecarlatreport.com
Issue Date: September 1, 2010
SUBSCRIBE NOW
Table Of Contents
Book Reviews
Assessing Depression in Adolescents
What is the Minimum Effective Dose of OROS Methylphenidate for Adolescents?
Trends in Medication Use for Children with Insomnia
Treating Depressed Adolescents Who Have Attempted Suicide: Results of the TASA Trial
Editor’s Perspective: Do Antidepressants Work in Kids?
Featured Book
  • CMFB2e_Cover.png

    Child Medication Fact Book for Psychiatric Practice, Second Edition (2023)

    All the important facts covering child and adolescent psychopharmacology.
    READ MORE
Featured Video
  • therapist_canstockphoto9201097.jpg
    General Psychiatry

    Using SAMe In Clinical Practice with Garrett Rossi, MD

    Read More
Featured Podcast
  • teen_depression.jpeg
    Child Psychiatry

    Assessment of Non-Suicidal Self-Injury in Children and Adolescents

    Learn how to assess and intervene with NSSI, including ideas for supporting autonomy while addressing the behavior.

    Listen now
Recommended
  • Approaches to Autism Intervention

    January 31, 2022
    canstockphoto2240982_child-bubbles_thumb.jpg
  • Currently Available Cannabis Products

    September 1, 2022
  • Interpreting Assessment Discrepancies from Multiple Sources

    October 17, 2022
    ChildAssessment.png
  • Approaches to Autism Intervention

    January 31, 2022
    canstockphoto2240982_child-bubbles_thumb.jpg
  • Currently Available Cannabis Products

    September 1, 2022
  • Interpreting Assessment Discrepancies from Multiple Sources

    October 17, 2022
    ChildAssessment.png
  • Approaches to Autism Intervention

    January 31, 2022
    canstockphoto2240982_child-bubbles_thumb.jpg
  • Currently Available Cannabis Products

    September 1, 2022
  • Interpreting Assessment Discrepancies from Multiple Sources

    October 17, 2022
    ChildAssessment.png

About

  • About Us
  • CME Center
  • FAQ
  • Contact Us

Shop Online

  • Newsletters
  • Multimedia Subscriptions
  • Books
  • eBooks
  • ABPN Self-Assessment Courses

Newsletters

  • The Carlat Psychiatry Report
  • The Carlat Child Psychiatry Report
  • The Carlat Addiction Treatment Report
  • The Carlat Hospital Psychiatry Report
  • The Carlat Geriatric Psychiatry Report

Contact

info@thecarlatreport.com

866-348-9279

PO Box 626, Newburyport MA 01950

Follow Us

Please see our Terms and Conditions, Privacy Policy, Subscription Agreement, Use of Cookies, and Hardware/Software Requirements to view our website.

© 2023 Carlat Publishing, LLC and Affiliates, All Rights Reserved.