Are sleep medications for children a good idea?

Children and sleep problems – they seem to go together like horse and carriage, as the old saying goes. In recent years, there has been an explosion in the number of medications—prescription and over-the-counter—that produce sleepiness. And, expectably, these medications are being increasingly relied upon.

The use of medications to help children sleep was examined through a recent survey of child psychiatrists in the U.S. conducted by Brown University. The study, reported in Science Daily, showed that 96 percent of participating child psychiatrists had recommended a sleep medication for a child at least once in the past month!

The researchers with the study found that the most important reason child psychiatrists prescribed sleep medication was to manage the effects of sleep disruption on daytime functioning. But the psychiatrists cited side effects and the lack of evidence regarding their effectiveness as significant barriers to their use. And despite the high frequency of use and the wide range of medications chosen, practitioners also expressed a number of significant concerns about the appropriateness of sleep medication in general for children.

All medications have their use, and Lucy Daniels Center child psychiatrists have at times recommended sleep medications for children. For example, we use them when sleep disturbance does not respond to other approaches and is so severe that it affects a child’s daytime function. Likewise, sleep medications may be useful to treat primary sleep disorders that emerge in childhood, particularly in adolescence.  But just because the medications are available – and sometimes very effective – does not mean that they are always—or even most often—the best solution.

Why? One reason is that children need to develop what we call mental muscles, and going to sleep is a skill as much as any other ability. It takes practice, learning and time for most children. If a medication does the job for the child, he or she may be deprived of the opportunity to learn abilities that are best developed in childhood.

A second reason is that sleep problems can often be a symptom of emotional conditions, such as those related to anxiety or depression. For example, in this study, almost one-third of child psychiatrists’ patients had significant sleep issues, although almost all were being seen for a wider scope of issues. Simply focusing upon the sleep with medication may result in a missed opportunity to address the more basic issue.

– Mental Health Matters! is written by the Lucy Daniels Center for Early Childhood and posted on the Carolina Parent Magazine's website, the Triangle's family resource - in print for over 21 years!  And online at www.carolinaparent.com.