Doctors commonly prescribe drugs for sleep difficulties to children even though the medications are not approved for use by children, a study in the journal Sleep finds.
The study looked at more than 18.6 million doctor visits that involved a sleeping problem in kids 17 and younger from 1993 to 2004. The researchers looked at visits to pediatricians, family doctors and psychiatrists.
In four out of five visits (81 per cent), the kids received a prescription for medication. Most of the children were between six and 12 years old.
Most commonly, the medication was a drowsiness-promoting antihistamine or a sedative, Milap C. Nahata of Ohio State University and colleagues found.
- Antihistamines, such as hydroxyzine, were recommended in 33 per cent of cases;
- Sedative drugs, known as alpha-2 agonists, in 26 per cent;
- Benzodiazepines, such as Valium or Ativan, in 15 per cent;
- Antidepressants in 6 per cent, and non-benzodiazepines in 1 per cent;
- A combination of drugs was offered to 19 per cent of the patients.
"Many of these medications prescribed lack FDA approved labeling to assure their effectiveness and safety in this population," the authors point out.
Psychiatrists were 3.6 times as likely as other doctors to prescribe a medication for sleep problems, while pediatricians were about twice as likely as other physicians to do so.
The reasons that these drugs are prescribed need to be examined, the researchers report. Strategies to minimize the use of unapproved drugs in children also need to be developed, they say.
As well as prescribing medications, doctors also recommended diet and nutritional approaches (for example, limiting caffeine in food and beverages) for 7 per cent of patients. Psychotherapy was recommended for 12 per cent, and mental health and stress management therapy for 17 per cent.
