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 language | English |
|---|---|
| Journal | Expert Opinion on Pharmacotherapy |
| DOIs | |
| Publication status | Accepted/In press - Jan 1 2019 |
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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 journal › Review article
}
TY - JOUR
T1 - Pharmacotherapeutic management of sleep disorders in children with neurodevelopmental disorders
AU - Bruni, Oliviero
AU - Angriman, Marco
AU - Melegari, Maria Grazia
AU - Ferri, Raffaele
PY - 2019/1/1
Y1 - 2019/1/1
N2 - 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.
AB - 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.
KW - drug effects
KW - insomnia
KW - melatonin
KW - neurodevelopmental disorders
KW - Sleep disorders
UR - http://www.scopus.com/inward/record.url?scp=85074462657&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85074462657&partnerID=8YFLogxK
U2 - 10.1080/14656566.2019.1674283
DO - 10.1080/14656566.2019.1674283
M3 - Review article
C2 - 31638842
AN - SCOPUS:85074462657
JO - Expert Opinion on Pharmacotherapy
JF - Expert Opinion on Pharmacotherapy
SN - 1465-6566
ER -