Treating insomnia in children and adolescents

Research Summary
Meg Guard
Research Assistant

In an article published in Current Psychiatry Reports, researchers reviewed current approaches for treating insomnia in children and adolescents. Although an estimated 25% of children have trouble sleeping, pediatric sleep disorders are often not identified, and thus, left untreated. Symptoms of insomnia in children include difficulty falling asleep once they’ve been put to bed, night wakings, inability to fall back asleep once awake, waking early in the morning, feeling chronically tired, seeming groggy and distracted, erratic or moody behavior, and behavior that resembles ADHD. Current treatment for pediatric insomnia includes prescription and over-the-counter medications, dietary supplements such as melatonin, and behavioral treatment. Behavioral treatments include implementing good sleep hygiene or cognitive behavioral therapy.  The researchers point out that some of the current medications used to treat pediatric insomnia are approved by the Federal Drug Administration (FDA) for other purposes, such as adult insomnia, but none of these medications are FDA approved to treat insomnia in children and adolescents. Due to the lack of scientific data to support the success of these medications, side effects remain a concern. According to this review, behavioral treatments seem to be more beneficial in improving insomnia symptoms in children. Behavioral treatments have also been shown to decrease the chances of relapse once treatment has stopped.  

In summary, the researchers provide four recommendations. First, children should be evaluated at routine check-ups so that sleep disorders can be diagnosed and treated early. Second, behavioral interventions should be the first line of treatment for pediatric insomnia. Third, melatonin should be considered as a second-line of treatment. The data reviewed by the researchers shows that melatonin helped improve insomnia symptoms, but the degree to which it helped was small. If you’re considering melatonin, consult your child’s pediatrician first. Given the lack of data, the researchers do not recommend using prescription medicines to treat insomnia in children and adolescents. Finally, the researchers note that if the previous recommendations are not successful, the child’s clinician should refer the child to a sleep specialist. Read the full review here.

Below are additional resources for information on sleep disorders and treatment:

Sleep disorders, assessments, and where to seek help

Going on a light diet: Avoid insomnia by managing your screens

Melatonin for children? A guide for parents

Using Melatonin to help children fall asleep