Friday, July 30, 2010

Children and Insomnia

There is a review from Medscape about an article that's coming out in the August edition of Sleep Medicine. The authors performed a nation-wide survey of child and adolescent psychiatrists about their patients with insomnia. Apparently, upto one-third of patients receiving psychiatric care have insomnia. At least one-fourth of those with insomnia receive either prescription or over-the-counter medications for their sleeping difficulty.

However, those surveyed expressed concerns about the side effects and lack of proof that medications for insomnia work. I guess this is why only one-fourth of their patients with insomnia received medications.

It's my opinion that medications are not a good long term strategy for children and adults that struggle with insomnia. Even if these medications have few side effects and are not physically addictive, patients can still develop psychological dependence to the medication. The patients often begin to believe they must have a pill to sleep, instead of using their body's own sleep drive and circadian rhythm to help them sleep.

Treating insomnia in children is very challenging and obviously common. Parents must be educated because the work really falls on their shoulders. The child can not be expected to do it alone. When dealing with adolescents, however, they need to become willing participants in their own insomnia treatment. Non-medication treatments for insomnia often work well in both children and adolescents, and it can be rewarding to see family dynamics improve once the child is sleeping better.

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