Sleep Drugs Often Prescribed for Kids

By Kathleen Doheny
WebMD Health News Reviewed by Louise Chang, MD

Aug. 1, 2007 -- Children with sleep problems are likely to be prescribed a sleeping pill or other medication approved only for adults, according to a new study.

When researchers from The Ohio State University and the University of Missouri evaluated 18.6 million children's doctor visits for sleep problems, they found that 81% of visits included a prescription for a medication. The study appears in the Aug. 1 issue of the journal Sleep.

"The findings raise concern because of the large number of patients affected," says researcher Milap C. Nahata, PharmD. Nahata is professor and division chairman at Ohio State's College of Pharmacy and professor of pediatrics and internal medicine at the College of Medicine. "We tend to jump on medication right away."

While he and other sleep experts agree that medication may sometimes help children with sleep problems, they suggest medication is best used in combination with other approaches, such as behavioral therapy. Nahata tells WebMD that studies of the medications in children are needed.

For the study, Nahata and his colleagues evaluated information from a large database, the National Ambulatory Medical Care Survey, from 1993 to 2004, to find out what doctors prescribed or advised when young patients came in for help with sleep problems.

Children were aged 17 and under, all experiencing sleep difficulties such as insomnia. Most visits were by children ages 6 to 12. Pediatricians, psychiatrists, family practice doctors, and others saw the patients.

Among the medications prescribed were sleeping pills such as Ambien and Sonata as well as other medications sometimes prescribed to help sleep problems, such as the antihistamine Atarax, the antidepressant Desyrel, and the high blood pressure medicine Catapres.

Antihistamines were most often prescribed for the children's sleep problems, given in 33% of the visits, followed by blood pressure drugs (26%), benzodiazepines such as the sleeping pill Restoril (15%), antidepressants (6%), and nonbenzodiazepine drugs such as the sleeping pills Ambien and Sonata (1%).

Doctors prescribing the medications that are not approved for use in children did so "off-label," a legal and common practice.

Nahata says his team did the study because there has not been a large study on the topic so far. The results surprised him, he tells WebMD.

"I was thinking one-third [of visits would involve prescription medication]," he says. Beyond the scope of the study, he says, was whether the medications prescribed were appropriate for the condition and how long the children used them.