CC BY 4.0 · Journal of Child Science 2018; 08(01): e172-e180
DOI: 10.1055/s-0038-1675222
Review Article
Georg Thieme Verlag KG Stuttgart · New York

Pediatric Insomnia: Update and Future Directions

Lisa Medalie
1   Departments of Pediatrics and Medicine, Pritzker School of Medicine, University of Chicago, Chicago, Illinois, United States
,
David Gozal
2   Department of Child Health, University of Missouri School of Medicine, Columbia, Missouri, United States
› Author Affiliations
Further Information

Publication History

29 August 2018

04 September 2018

Publication Date:
24 October 2018 (online)

Abstract

Throughout their childhood, pediatric insomnia impacts approximately 25% of all children in the general population. Although it can occur as an isolated condition, it commonly associates with other comorbidities, such as autism, developmental delay, and psychiatric disorders. Careful and detailed history is essential, and sleep logs and actigraphy are useful tools in the assessment and diagnosis of pediatric insomnia. However, polysomnography is usually not warranted in the assessment of pediatric insomnia unless underlying medically-based sleep symptoms are concurrently identified and justify such test. In the majority of cases, behavioral interventions are the recommended approach for treatment. Despite the fact that many pharmacological approaches are used for child insomnia off-label, there are currently no FDA (Food and Drug Administration) approved medications for the management of pediatric insomnia. The high prevalence of pediatric insomnia, coupled with the low number of providers, who are formally trained in behavioral treatment for this prevalent condition, highlights the urgent need for improving primary care practitioner awareness, while expanding alternative routes to access to care, such as interactive virtual technology-based treatments, parent education and manuals, along with ongoing efforts to increase professional training opportunities.

 
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