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Open Access 16-04-2024 | Insomnia | GUIDELINE

European expert guidance on management of sleep onset insomnia and melatonin use in typically developing children

Authors: Oliviero Bruni, Maria Breda, Lino Nobili, Ingo Fietze, Oscar Ramon Sans Capdevila, Claude Gronfier

Published in: European Journal of Pediatrics

Abstract

Sleeping problems are prevalent among children and adolescents, often leading to frequent consultations with pediatricians. While cognitive-behavioral therapy has shown effectiveness, especially in the short term, there is a lack of globally endorsed guidelines for the use of pharmaceuticals or over-the-counter remedies in managing sleep onset insomnia. An expert panel of pediatric sleep specialists and chronobiologists met in October 2023 to develop practical recommendations for pediatricians on the management of sleep onset insomnia in typically developing children. When sleep onset insomnia is present in otherwise healthy children, the management should follow a stepwise approach. Practical sleep hygiene indications and adaptive bedtime routine, followed by behavioral therapies, must be the first step. When these measures are not effective, low-dose melatonin, administered 30–60 min before bedtime, might be helpful in children over 2 years old. Melatonin use should be monitored by pediatricians to evaluate the efficacy as well as the presence of adverse effects.

Conclusion: Low-dose melatonin is a useful strategy for managing sleep onset insomnia in healthy children who have not improved or have responded insufficiently to sleep hygiene and behavioral interventions.

What is Known: • Pediatric insomnia is a common disorder and impacts children's emotional, behavioral, and cognitive functioning, as well as parents' sleep and daytime functioning. • There is no consensus in Europe on the management of sleep onset insomnia and the use of melatonin in typically developing children.
What is New: • A group of European experts has compiled a set of recommendations for the management of insomnia, developing a step-by-step approach. • Sleep hygiene, behavioral strategies, and finally low-dose melatonin represent valid strategies for managing sleep onset insomnia.

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Title: European expert guidance on management of sleep onset insomnia and melatonin use in typically developing children
Authors: Oliviero Bruni
Maria Breda
Lino Nobili
Ingo Fietze
Oscar Ramon Sans Capdevila
Claude Gronfier
Publication date: 16-04-2024
Publisher: Springer Berlin Heidelberg
Keywords: Insomnia
Somnology
Pediatric Neurology
Child and Adolescent Psychiatry
Child and Adolescent Psychiatry
General Medicine
Published in: European Journal of Pediatrics
Print ISSN: 0340-6199
Electronic ISSN: 1432-1076
DOI: https://doi.org/10.1007/s00431-024-05556-w

At a glance: The STEP trials

Springer Medicine

European expert guidance on management of sleep onset insomnia and melatonin use in typically developing children

Abstract

At a glance: The STEP trials

Springer Medicine

Abstract

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