Have you tried everything you can think of at home to help him or her get a good night’s sleep to no avail? If you answered yes, rest assured you are not alone. Studies suggest that up to 80% of children with neurodevelopmental disorders, such as Autism Spectrum Disorder (ASD) and Angelman Syndrome, are reported to have disruptions in sleep.1 Most experts agree that the first line of defense against sleep problems for children is what’s known as practicing good “sleep hygiene”. This includes a consistent bedtime routine which promotes good sleep habits. But what if you’ve got a bedtime routine established, and you’ve tried all the tricks in the book to help you child fall asleep and stay asleep, but it’s just not enough? That’s when you may wish to consider the possibility of adding a sleep medication or supplement for your child.
Are sleep medications safe? While there are many medications, supplements, vitamins, and even herbal remedies out there which tout the ability to improve sleep, there are none that are currently approved by the US Food and Drug Administration specifically for treating insomnia in the pediatric population. As with any medication or supplement, always consult with your child’s physician before you begin using any kind of sleep medication for your child, even if it is available over-the-counter. Having said that, there are many medications and supplements currently being used to treat sleep disorders in children. One of the most commonly recommended is Melatonin, which is typically readily available as a supplement or vitamin. Melatonin is generally considered to be safe for most children and adults when taken as recommended.
Which medication is right for my child? This is, of course, a question best left to your child’s physician to determine. What we can tell you, however, is the different types of medications frequently prescribed or recommended for sleep disorders in children, including children with special needs. This way you can research medications further and be well-informed if or when you choose to discuss the topic with your child’s physician. First, let’s discuss Melatonin a bit more. Melatonin is a hormone that naturally occurs within our bodies. It is primarily responsible for helping us to maintain our Circadian rhythms, which are the body’s natural way of establishing and maintaining sleep and wake cycles. Melatonin is typically available for purchase over-the-counter, often in the form of a vitamin. “Gummies” or chewable vitamins, can be especially easy for children to take, but be careful to keep them where children cannot access them, as children are sometimes tempted to eat gummies like they would any other candy. Also make sure to have children brush their teeth after eating a chewable vitamin, since the sugary and sticky nature of the vitamin can promote cavities.
What about prescription medications? There are lots of prescription medications out there commonly prescribed to treat sleep disorders. Of course, in children, particularly in children with special needs, your child’s physician will take many factors into account before determining whether a sleep medication is right for your child. They may consider your child’s age, medical history, current sleep difficulties, and other medications they may be taking, for instance. They may have parents fill out questionnaires or screening forms to help the physician get a better understanding of the sleep problems your child is experiencing. Once a medication is recommended, the physician will determine the lowest effective dose for your child. For children with ASD, an iron supplement may be recommended, as low iron is sometimes seen in children with ASD, and low iron can be associated with sleep disturbances such as Restless Leg Syndrome. Additionally, there are other medications which have been prescribed for children with sleep disturbances, such as ramelteon, clonidine, gabapentin, clonazepam, and trazodone. These kinds of medications may be considered by you and your child’s physician, typically as a last line of defense after other options to improve sleep have been exhausted.
Should I consider natural remedies first? There are some natural remedies, such as herbal teas and supplements, which may help with sleep. Before we go into detail about these remedies, first is a reminder that just because these remedies are considered “natural”, they still should be treated as any other new medication. Always review with your child’s physician first, as natural remedies can still potentially cause allergic reactions, can interact with other medications, or may otherwise not be appropriate for your child. Natural and herbal remedies sometimes used for children include: chamomile (usually in the form of a tea), magnesium (typically in supplement or vitamin form), lavender (aromatherapy), and california poppy (non-opiate and typically sold as liquid drops). In addition to these herbs, also remember the importance of daily physical activity as a natural remedy to improve sleep. If your child is not active enough during the day, their body may not be tired enough for sleep at night.
Cite: 1. Jan JE, Owens JA, Weiss MD, et al. Sleep hygiene for children with neurodevelopmental disabilities. Pediatrics 2008;122:1343–50.