Many Children in Mental Health Treatment Medicated for Insomnia

Parents and their children are both increasingly turning to the medicine cabinet to meet their sleep needs. One specific population of school-aged kids and adolescents seems to be the most medicated for sleep. Nearly a third of children in therapy for psychiatric or behavioral disorders are treated for insomnia using prescription and over-the-counter medications, a new study suggests.

Nearly all of the 1,300 participating members of the American Academy of Child and Adolescent Psychiatry said they prescribed at least one sleep medication per month. About 88 percent said they recommended over-the-counter treatments for insomnia.

Recommended medications included antihistamines and the antidepressant trazadone, which is often prescribed off-label for insomnia. Clinicians surveyed in the study also prescribed drugs with psychiatric or behavioral effects such as antipsychotics and anticonvulsants for insomnia.

The principal author of the study notes that most often the sleep medications are used to manage the effects of sleep disruption on daytime functioning. The average participating psychiatrist reported seeing about 70 children per month. Older children were more frequently treated for insomnia.

While most insomnia patients were older than six years old, clinical psychiatrists reported more than 20 percent of preschool-aged patients were affected by insomnia.

The complete study will be published in the August 1st issue of Sleep Medicine.

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“Ambien Zombies”, sleepwalking fears and facts

Last night, Fox News Boston aired the special report “Is Ambien creating a nation of zombies?” The segment called attention to dangerous or even deadly sleepwalking episodes linked to the prescription sleep drug Ambien.



While these incidents are a reminder that side effects can occur, millions of people regularly take Ambien and other prescription hypnotics without experiencing any problems.

You can minimize the risk if you take Ambien exactly as prescribed by your doctor, moments before bedtime. Never increase dosage or begin taking additional medications without consulting your doctor. And don’t use alcohol before or after taking Ambien. Allow for a full nights sleep when you take the drug.

The FDA warns in its Medication Guide for Ambien, “You may get up out of bed while not being fully awake and do an activity that you do not know you are doing. The next morning, you may not remember that you did anything during the night.”

The AASM recognizes Ambien as a safe short-term treatment for insomnia. For severe or chronic cases we recommend seeing a board-certified sleep specialist for further treatment options, such as cognitive behavioral therapy. To find a sleep specialist contact an AASM-accredited sleep center near you.

Find out more about Ambien and other sleep medications.

Or follow us on Twitter: twitter.com/aasmorg.

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FDA Approves Silenor for Insomnia

The makers of sleeping pills such as Ambien, Lunesta and Rozerem will soon have new competition. On March 17 the FDA granted approval to Somaxon Pharmaceuticals for its drug Silenor. Somaxon reports that the insomnia medication should be available in the second half of 2010.

But Silenor isn’t for people who have trouble falling asleep. It takes about 3.5 hours for the drug to reach its peak concentration in the blood.

So the FDA approved Silenor to help people who struggle with “sleep maintenance.” It may benefit people who tend to wake up during the night or early in the morning and struggle to return to sleep.

The drug that Silenor contains is called “doxepin.” For years this histamine-blocking drug has been used at high doses as an antidepressant.

It has been known that doxepin also improves sleep. But at high doses it may cause severe side effects. This prevented the drug from being used as a common sleep aid.

Now studies have shown that doxepin can reduce the symptoms of insomnia at doses as low as 3mg or 6 mg. Side effects are minimal at these low doses. The FDA recommends that older adults start with the 3 mg dose.

One of these studies was published in the journal Sleep in 2007. It involved 66 adults with chronic primary insomnia. They had a mean age of 42 years, and 70 percent were women. Both 3 mg and 6 mg doses of doxepin were compared with a placebo.

Results show that doxepin reduced the time spent awake after falling asleep by about 22 to 23 minutes. It increased total sleep time by about 26 to 29 minutes. But it did not reduce the number of awakenings during the night.

Last year the Sleep Education Blog reported an increase in prescriptions for sleeping pills. The use of sleeping pills by young adults also rose dramatically.

The AASM offers these Guidelines for Taking Sleep Medications. Contact your doctor or pharmacist if you have any other questions about taking sleeping pills.

You also should ask your doctor about cognitive behavioral therapy for insomnia. It is a safe and effective treatment option.

Get help for insomnia at an AASM-accredited sleep center near you.

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