Melatonin for the management of sleep disorders in children and adolescents Flashcards
What is the prevalence of difficulties in initiating and maintaining sleep?
15-25% of children and adolescents
What is the definition of insomnia?
Loss of daytime function resulting from unsatisfactory sleep
What are the symptoms of insomnia?
- Fatigue
- Inattention
- Irritability
- Lack of energy
- Anxiety
- Depression
- Learning difficulties
- Poor school performance
What is the delayed sleep phase type of problem?
initiation of sleep significantly later than the desired bedtime. Sleep latency – the amount of time between lying down to sleep and onset of sleep – is increased to longer than the normal 30 mins. The shortened sleep time is often then associated with difficulty awakening in the morning
What is behavioral insomnia - sleep onset type?
Special conditions are required of caregivers before the child goes, or returns, to sleep at night
What is behavioral insomnia - limit setting type?
Child stalls or refuses to go to bed or to return to bed and the caregiver demonstrates unsuccessful limit-setting behaviours
What medical issues can lead to insomnia?
- Sleep apnea
- Anxiety
- Depression
- Inappropriate use of media at bedtime
What are recommendations re: sleep hygiene?
- Consistent routine
- Stable bedtime
- Stable morning wake time
- Age-appropriate number of hours in bed
- A dark and quiet sleep space
- Avoiding hunger (and eating) prior to bedtime
- Relaxation via strict avoidance of screens and encourage reading prior to bedtime
What is the dosing of melatonin?
Melationin 3-10mg PO 30-60min prior to bedtime
Which types of sleep disorders have melatonin been helpful?
- Delayed sleep phase type
- Sleep-onset association type
- ADHD
- Austism
Maybe helpful in: - Intractable epilepsy
- Neurodevelopmental disabilities
- Angelman syndrome