Kids often get unapproved drugs for sleep problems

NEW YORK (Reuters Health) - Doctors commonly prescribe drugs to children and teens with sleep difficulties that are not approved for use by patients in these age groups, a new study shows.

Eighty-one percent of physician visits for sleep problems by children and teens ended in a prescription for some type of medication, most commonly a drowsiness-promoting antihistamine or a sedative, Dr. Sasko D. Stojanovski of The Ohio State University College of Pharmacy in Columbus and colleagues found.

There is currently no Food and Drug Administration-approved medication for treating insomnia in children, the researchers point out.

The reasons that these drugs are prescribed, along with strategies to minimize the use of unapproved drugs in this population need to be examined, the researchers report in the medical journal Sleep.

To better understand how frequently children are prescribed drugs for their sleep problems, Stojanovski and his colleagues looked at data collected between 1993 and 2004 from the National Ambulatory Medical Care Survey on patients ages 17 or younger, which included roughly 18.6 million physician visits. School-aged children between 6 and 12 years old represented the greatest proportion of these visits.

Doctors recommended diet and nutritional approaches (for example, limiting caffeine in food and beverages) for 7 percent of patients. Psychotherapy was recommended for 12 percent, and mental health and stress management therapy for 17 percent.

However, as mentioned, 81 percent of the young patients were offered a prescription for medication. This included an antihistamine, such as hydroxyzine, in 33 percent; sedative drugs, known as alpha-2 agonists, in 26 percent; benzodiazepines, such as Valium or Ativan, in 15 percent; antidepressants in 6 percent, and non-benzodiazepines in 1 percent. Nineteen percent of the patients were given a combination of drugs.

Psychiatrists were 3.6 times as likely as other doctors to prescribe a medication for sleep problems, while pediatricians were about twice as likely as other physicians to do so.

The researchers point out that their study was unable to investigate whether children were taking over-the-counter sleep-inducing drugs or herbal medicines.

"The findings of this study suggest that physicians frequently prescribed medications for sleep difficulties in children in U.S. outpatient settings," they conclude. "Of particular concern is the prescribing of many unapproved medications for this population."

SOURCE: Sleep, August 1, 2007.