title: Sleep-promoting medications in children: physician prescribing habits in Southwestern Ontario, Canada.
abstract: BACKGROUND
  Research indicates that physicians may frequently use pharmacotherapy to treat pediatric insomnia despite minimal safety data and very limited indications. Canadian data on the subject are lacking. This study aimed to determine physicians' views on and prescribing habits for sleep-promoting over-the-counter medication (OTCM) and prescription (RXM) medications for children.
  
  
  METHODS
  A modified 26-item version of the 'Pediatric Sleep Medication Survey', originally developed by Judith Owens and colleagues, was sent to 100 pediatricians and a random sample of 421 family physicians in Southwestern Ontario, Canada.
  
  
  RESULTS
  A total of 67 returned surveys were sufficiently complete for analysis. Sixty-one respondents indicated their specialty (28 pediatricians, 33 family physicians). In a typical 6-month period, 89% and 66% of respondents have recommended OTCM and RXM, respectively, for children with sleep problems. Only 20% have received any formal training on pediatric sleep disorders. The most common circumstances and sleep problems for which OTCM or RXM were recommended were mood disorders, developmental delay and attention deficit hyperactivity disorder (ADHD) (56, 40, and 39%, respectively), and insomnia, bedtime struggles/delayed sleep onset and circadian rhythm disorders (52, 48, and 28%, respectively). A total of 30% recommended OTCM or RXM to otherwise healthy children with sleep problems. Melatonin (73%), OTC antihistamines (41%), antidepressants (37%), and benzodiazepines (29%) were the most commonly recommended OTCM and RXM, respectively.
  
  
  CONCLUSIONS
  Respondents in our sample frequently use pharmacotherapy to treat pediatric sleep problems; few have received any training in this area. Our findings indicate the need for evidence-based guidelines and regular physician training in the management of pediatric sleep disorders.
authors: Department of Pediatrics, Western University, London, Ontario, Canada; Lawson Health Research Institute, London, Ontario, Canada. Electronic address: dirk.bock@lhsc.on.ca.
authors: Dirk E
authors: DE
authors: Bock
authors: Department of Pediatrics, Western University, London, Ontario, Canada.
authors: Elizabeth
authors: E
authors: Roach-Fox
authors: Department of Pediatrics, Western University, London, Ontario, Canada; Lawson Health Research Institute, London, Ontario, Canada; Children's Health Research Institute, London, Ontario, Canada; Brescia University College, Western University, London, Ontario, Canada.
authors: Jamie A
authors: JA
authors: Seabrook
authors: Department of Pediatrics, Western University, London, Ontario, Canada; Children's Health Research Institute, London, Ontario, Canada.
authors: Michael J
authors: MJ
authors: Rieder
authors: Department of Pediatrics, Western University, London, Ontario, Canada; Children's Health Research Institute, London, Ontario, Canada.
authors: Doreen
authors: D
authors: Matsui
mesh_terms: D000928:Antidepressive Agents / Q000627:therapeutic use; D001289:Attention Deficit Disorder with Hyperactivity / Q000188:drug therapy; D001569:Benzodiazepines / Q000627:therapeutic use; D003430:Cross-Sectional Studies; D002658:Developmental Disabilities / Q000188:drug therapy; D006633:Histamine Antagonists / Q000627:therapeutic use*; D006801:Humans; D006993:Hypnotics and Sedatives / Q000627:therapeutic use*; D008550:Melatonin / Q000627:therapeutic use*; D056687:Off-Label Use / Q000706:statistics & numerical data; D009864:Ontario; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D007319:Sleep Initiation and Maintenance Disorders / Q000188:drug therapy; D012893:Sleep Wake Disorders / Q000188:drug therapy; D011795:Surveys and Questionnaires
chemical_list: D000928:Antidepressive Agents; D006633:Histamine Antagonists; D006993:Hypnotics and Sedatives; D001569:Benzodiazepines; D008550:Melatonin
keywords: Insomnia; Over-the-counter; Pediatric; Prescription medication; Sleep disturbance; Survey