Pharmacotherapy of Insomnia in Children

Insomnia is defined as the inability to fall asleep and/or the inability to maintain sleep to the point that it has a negative impact on time awake. Insomnia in adults may lead to daytime fatigue and sleepiness but in children, the lack of quality sleep may lead to daytime behavioral problems such as hyperactivity and academic difficulty. The pharmacological treatment of insomnia in children is a challenging problem for clinicians since there is paucity of Food and Drug Administration (FDA) approved. Parents often seek medical attention for their children when their own or other members of the family’s sleep schedule has been disrupted. The clinician has to take into account the entire family when evaluating a child and making therapeutic recommendations. When evaluating a child with insomnia, it is not only important to take a thorough history of the child’s sleep schedule but it also involves getting a detailed evaluation of the other family member’s sleep history. The pharmacological management of insomnia is dependent on the child’s age. The primary healthcare physician may have limited training in pediatric sleep disorders. Although the mainstay treatment for insomnia in children is behavioral therapy, in this chapter, we will provide a review of the medications that may be used as an adjunct treatment for pediatric insomnia.