title: Insomnia in childhood and adolescence: clinical aspects, diagnosis, and therapeutic approach.
abstract: OBJECTIVE
  To review the clinical characteristics, comorbidities, and management of insomnia in childhood and adolescence.
  
  
  METHODS
  This was a non-systematic literature review carried out in the PubMed database, from where articles published in the last five years were selected, using the key word "insomnia" and the pediatric age group filter. Additionally, the study also included articles and classic textbooks of the literature on the subject.
  
  
  RESULTS
  During childhood, there is a predominance of behavioral insomnia as a form of sleep-onset association disorder (SOAD) and/or limit-setting sleep disorder. Adolescent insomnia is more associated with sleep hygiene problems and delayed sleep phase. Psychiatric (anxiety, depression) or neurodevelopmental disorders (attention deficit disorder, autism, epilepsy) frequently occur in association with or as a comorbidity of insomnia.
  
  
  CONCLUSIONS
  Insomnia complaints in children and adolescents should be taken into account and appropriately investigated by the pediatrician, considering the association with several comorbidities, which must also be diagnosed. The main causes of insomnia and triggering factors vary according to age and development level. The therapeutic approach must include sleep hygiene and behavioral techniques and, in individual cases, pharmacological treatment.
authors.affiliation: Faculdade de Medicina, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, RS, Brazil. Electronic address: nunes@pucrs.br.
authors.forename: Magda Lahorgue
authors.initials: ML
authors.lastname: Nunes
authors.affiliation: Department of Social Development and Psychology, Universidade La Sapienza, Rome, Italy.
authors.forename: Oliviero
authors.initials: O
authors.lastname: Bruni
mesh_terms: D000293:Adolescent; D002493:Central Nervous System Diseases / Q000150:complications; D002648:Child; D002675:Child, Preschool; D003863:Depression / Q000150:complications; D006801:Humans; D007223:Infant; D065886:Neurodevelopmental Disorders / Q000150:complications; D007319:Sleep Initiation and Maintenance Disorders / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology / Q000628:therapy
keywords: Adolescence; Adolescência; Childhood; Distúrbios do sono; Infância; Insomnia; Insônia; Sleep disorders