Pharmacotherapeutic management of sleep disorders in children with neurodevelopmental disorders

Oliviero Bruni, Marco Angriman, Maria Grazia Melegari, Raffaele Ferri

Research output: Contribution to journalReview article

Abstract

Introduction: Sleep disturbances are highly prevalent in children with neurodevelopmental disabilities. Without appropriate treatment, sleep disorders can become chronic and last for many years. However, there are no sleep medications approved by the United States Food and Drug Administration and only one has been approved by the European Medicines Agency for pediatric insomnia; thus, most medications are prescribed off-label. Areas covered: In this narrative review, the authors highlight and summarize the most common drugs and supplements used for the treatment of sleep problems in children with neurodevelopmental disabilities. Recommendations are formulated regarding the use of melatonin and melatonin receptor agonists, sedating antidepressants, antipsychotics, antihistamines, gabapentin, clonidine and orexin receptor antagonists, and benzodiazepines and hypnotic benzodiazepine receptor agonists. Expert opinion: The choice of pharmacological agents and their dosage should be individualized taking into consideration multiple factors, including the severity and type of sleep problem and the associated neurological pathology. Melatonin is widely used and safe in children with neurodevelopmental conditions. Gabapentin, clonidine, trazodone, and mirtazapine hold promise but require further study. Supplements (iron, vitamin D, and 5-hydroxytryptophan) might be helpful. Due to the lack of clinical data, there is still uncertainty concerning dosing regimens and tolerability.

Original languageEnglish
JournalExpert Opinion on Pharmacotherapy
DOIs
Publication statusAccepted/In press - Jan 1 2019

Fingerprint

Sleep
Disabled Children
Clonidine
Melatonin
Melatonin Receptors
Trazodone
5-Hydroxytryptophan
Histamine Antagonists
Expert Testimony
Sleep Initiation and Maintenance Disorders
GABA-A Receptors
United States Food and Drug Administration
Hypnotics and Sedatives
Benzodiazepines
Vitamin D
Antidepressive Agents
Antipsychotic Agents
Uncertainty
Iron
Pharmacology

Keywords

  • drug effects
  • insomnia
  • melatonin
  • neurodevelopmental disorders
  • Sleep disorders

ASJC Scopus subject areas

  • Pharmacology
  • Pharmacology (medical)

Cite this

Pharmacotherapeutic management of sleep disorders in children with neurodevelopmental disorders. / Bruni, Oliviero; Angriman, Marco; Melegari, Maria Grazia; Ferri, Raffaele.

In: Expert Opinion on Pharmacotherapy, 01.01.2019.

Research output: Contribution to journalReview article

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