Authors: Mandeep Kaur, Sabhyata Agrawal.
Objective: Pediatric insomnia disorders significantly affect the lives of the patients and their caregivers. Currently available behavioral management techniques and therapy are not effective for everyone. There is extensive literature on the efficacy and safety data on melatonin however, it too can be ineffective for some patients. The aim of this narrative review is to provide an analysis of various pharmacological and nonpharmacological options, other than melatonin, that can be considered as treatment options for pediatric insomnia.
Methods: The databases PubMed, Medline, Scopus were searched using the key terms “pediatric insomnia”, “insomnia in children”, “insomnia in adolescents”, “therapies in pediatric insomnia”, “behavioral management of pediatric insomnia, “pharmacological agents in pediatric insomnia”, “complementary treatment of pediatric insomnia”, and “herbal therapies in pediatric insomnia” which yielded 128 articles. Additionally, database clinicaltrials.gov was searched for trials with key words “insomnia in children”, “insomnia in adolescents” and “pediatric insomnia” which yielded 42 studies. The articles and studies were reviewed as pertinent to the topic.
Results: Based on the search, evidence for effectiveness for several novel therapeutics such as melatonin agonists, orexin receptor antagonists, nutritional supplements, herbal medicines, complementary and alternative treatment options came in to light. However, a remarkable deficit of large-scale studies depicting the efficacy and safety of all these in pediatric populations was noted.
Conclusions: With pediatric insomnia disorders being a challenging clinical situation for clinicians not just limited to one specialty, a joint effort is needed to explore these treatment options with help of large-scale clinical studies.
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