The use of pharmacotherapy in the treatment of pediatric insomnia in primary care: rational approaches. A consensus meeting summary.
OBJECTIVE
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.


METHODS
A multidisciplinary task force developed under the auspices of the American Academy of Sleep Medicine, which included experts in pediatric sleep medicine, psychiatry, pharmacology, neurology, and general pediatrics.


METHODS
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.


METHODS
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.
Owens
Judith A
JA
Brown Medical School and Hasbro Children's Hospital, Providence, RI, USA. Owensleep@aol.com
Babcock
Deborah
D
Blumer
Jeffrey
J
Chervin
Ronald
R
Ferber
Richard
R
Goetting
Mark
M
Glaze
Daniel
D
Ivanenko
Anna
A
Mindell
Jodi
J
Rappley
Marsha
M
Rosen
Carol
C
Sheldon
Stephen
S
D002648:Child; D003153:Community Health Services; D004334:Drug Administration Schedule; D006801:Humans; D006993:Hypnotics and Sedatives / Q000627:therapeutic use*; D008403:Mass Screening / Q000379:methods; D017410:Practice Guidelines as Topic; D011320:Primary Health Care / Q000379:methods*; D007319:Sleep Initiation and Maintenance Disorders / Q000188:drug therapy*
D006993:Hypnotics and Sedatives