title: Pharmacological treatment of sleep disturbance in developmental disabilities: a review of the literature.
abstract: Sleep disturbance is a common problem in children with developmental disabilities. Effective pharmacologic interventions are needed to ameliorate sleep problems that persist when behavior therapy alone is insufficient. The aim of the present study was to provide an overview of the quantity and quality of pharmacologic research targeting sleep in children with developmental disabilities. Efficacy studies of medications most likely to be prescribed to children are reviewed in detail. Medline and PsychInfo searches were performed to identify relevant clinical trials and case reports, published between 1975 and 2009. Key search terms included sleep, children, antihistamines, alpha adrenergic agonists, antidepressants, antipsychotics, melatonin, ramelteon, benzodiazepines, and nonbenzodiazepines. The literature search identified 58 articles that met the inclusion criteria. Well-controlled studies employing both objective polysomnography and subjective sleep measures are needed to determine the efficacy and safety of currently prescribed pediatric sleep medicines. Melatonin appears to be the most widely assessed agent and safest choice for children with developmental disabilities. Trazodone, mirtazapine, and ramelteon hold promise but require further study.
authors.affiliation: The Nisonger Center UCEDD, The Ohio State University, I/DD Psychology, 1581 Dodd Drive, Columbus, OH 43210, United States. hollway.3@osu.edu
authors.forename: Jill A
authors.initials: JA
authors.lastname: Hollway
authors.forename: Michael G
authors.initials: MG
authors.lastname: Aman
mesh_terms: D000928:Antidepressive Agents / Q000627:therapeutic use; D014150:Antipsychotic Agents / Q000627:therapeutic use; D002492:Central Nervous System Depressants / Q000627:therapeutic use; D002658:Developmental Disabilities / Q000150:complications*; D006801:Humans; D006993:Hypnotics and Sedatives / Q000627:therapeutic use*; D008550:Melatonin / Q000627:therapeutic use*; D012893:Sleep Wake Disorders / Q000150:complications* / Q000188:drug therapy*
chemical_list: D000928:Antidepressive Agents; D014150:Antipsychotic Agents; D002492:Central Nervous System Depressants; D006993:Hypnotics and Sedatives; D008550:Melatonin