A new study shows physicians in the U.S often prescribe children and teens with sleep difficulties drugs that have not been approved for use in their age groups. The report was published in the Aug. 1 issue of the journal, Sleep.
Using data from the National Ambulatory Medical Care Survey, a team of doctors from Ohio State University, led by Dr. Sasko D. Stojanovski conducted a study of 18.6 million doctor visits made from 1993-2004 by patients 17 years of age and younger, all of whom were suffering from insomnia. Antihistamines that promoted drowsiness or a sedative turned out to be the most commonly prescribed type of drugs in 81 percent of the visits. To cite an example example, alpha-2-agonist drugs (such as Catapres or Tenex) and antihistamines (such as Atarax) that have sedative effects secondary to their intended use, were prescribed to 26% and 33% of the children diagnosed with sleep disorders.
It was found that Psychiatrists were 3.6 times more apt to recommend medication for insomnia and other sleep problems, ahead of pediatricians who were twice as probable to do this compared to other medical practitioners.
People generally connect sleep problems with stress, depression and such and consider them adult problems. But the study observed that more and more children are having sleep problems and that more often than not, they are treated with medication. The study authors found this disturbing because sleep deprivation could result in irritability, impaired concentration, headaches and even behavior very similar to that of attention-deficit hyperactivity disorder. And what concerned the scientists even more was that many of the medications prescribed had not been approved for children and teens.
Of the 18.6 million patients, 7% of patients received dietary counseling, while only 22% were given behavioral therapies such as psychotherapy or stress management counseling.
The data did not, however, provide any information about whether the prescribed medications were appropriate, what the dosages were, or for how long they had been prescribed.
The researchers did highlight the fact that at present there is no drug to treat insomnia in children that is approved by the Food and Drug Administration.
The researchers were interested in the reason for these drugs being prescribed and felt that the need for developing policies to curtail the use of unapproved drugs in this group should be examined.
According to Milap Nahata, study senior author and professor of medicine from Ohio State University, altered habits may be responsible as well with only 20% of teenagers getting the recommended nine hours of sleep.
Doctors recommended diet and nutritional approaches (for example, limiting caffeine in food and beverages) for only 7 percent of the patients. Psychotherapy was recommended for 12 percent, and mental health and stress management therapy for 7 percent, but 81% were prescribed drugs including hydroxyzine. Only 19% of the patients received a prescription along with a recommendation for behavior therapy.
Nahata adds, however, that it is reasonable for doctors to prescribe a sleep aid for a short time, to smooth the transition while behavioral changes are made. “Behavioral approaches are almost always worth trying. It's very easy to develop some disorders, and it can be very easy to get rid of them, as well." he says.
