Written by Dr. Robert A. Lowenstein MD
Children who have difficulty in going to bed or staying asleep cause major problems for many families. A child’s inability to sleep causes them to suffer with daytime sleepiness, irritability, and poor school performance, and also causes parents to endure days of tiredness, irritability, and lack of concentration.
In most cases, emotional stress connected to issues or changes in a child’s life is the culprit. Learning challenges at school or problems in peer relationships, anxiety, fears, and separation problems at home, as well as too much noise and excitement before bed time needs to be addressed.
We often first advise parents to change their child’s night time routine by turning off the TV or computer in their room, helping the child to maintain a consistent and quiet routine after dinner, with time allowed for them to settle in, and insisting on their sleeping in their own room. Breaking old habits is very difficult for children and requires patience and stick-to-it ness.
If this does not help, over-the counter (OTC) preparations like Valerian root, St. John’s wort, and Humulus lupulus (hops) have been proven to be of some value. Melatonin to correct circadian rhythm (day-night cycle) disturbances is often helpful. While OTC preparations are generally free of side effects, they are not entirely free of safety concerns, and need to be closely monitored by a medical professional. It is very important for parents to tell their child’s psychiatrist or pediatrician of their use as they may interfere with other medical treatments or be in themselves a cause of some harm.
Medications such as Rozerem (or ramelteon, a melatonin enhancer), Catapres (or clonidine used to treat ADHD), various antidepressants, as well as antihistamines, are prescribed because of their sedating properties.
It is very important to know that medications are not meant to be used indefinitely, and drug-free periods are recommended.