Sleep problems in children and teenagers: sleep medicine or other strategies?
If your child is having problems with getting to sleep or staying asleep, medicine won’t necessarily fix the problem.
In Australia, sleep medicines are rarely used to help children and teenagers sleep because medicines can have side effects. Even herbal or ‘natural’ remedies can have side effects.
Before you talk with your GP about sleep medicines for your child, it’s always best to try sleep and lifestyle changes to help your child sleep better. These changes include:
- introducing better sleep habits
- limiting food and drinks with caffeine
- doing more physical activity.
If better sleep and eating habits aren’t helping, talk with your GP – especially if your child’s sleep problems are affecting their wellbeing, schoolwork or relationships. Also seek help if sleep problems are making your child anxious, or if the problems go on for more than 2-4 weeks.
Using sleep medicines for children and teenagers
Sometimes sleep problems continue even after children try better sleep habits and make other changes. These problems are called persistent sleep problems. When children have persistent sleep problems, doctors might sometimes prescribe a medicine like melatonin or a sedative.
If your doctor prescribes sleep medicine for your child, the doctor will recommend other strategies for your child as well. This combined approach will help to resolve your child’s problems faster. It also means the medicine won’t be needed for as long, and your child will keep sleeping better when they stop taking the medicine.
Some sleep medicines are available without a prescription – for example, in health food shops or over the counter in pharmacies. If you want to use one of these medicines, always talk about it with your doctor first.
And always check on the side effects of over-the-counter and prescribed sleep medicines by asking your doctor or pharmacist.
You should give your child sleep medicine only if your doctor advises you to do so and only if your doctor is supervising your child’s treatment. Never give your child more than the recommended dose of any medicine.
Herbal sleep remedies
Herbal or ‘natural’ sleep remedies – like chamomile, hops, passion flower and St John’s wort – are available in many health food shops, but there isn’t much evidence to show that they help with sleep problems.
Valerian, omega-3 and omega-6 fatty acids (fish oil) might improve sleep quality in some people. These supplements don’t have many side effects, but there isn’t enough evidence to show that they help.
Herbal sleep remedies don’t go through the same testing as medicines prescribed by your doctor or bought over the counter at your pharmacy.
Mixing prescription medicine and over-the-counter medicine or herbal remedies from a pharmacy or health food shop can be very dangerous. Always check with your doctor or pharmacist first.
Iron
If your child has restless leg syndrome or periodic limb movement disorder and has low iron stores, your doctor might recommend additional iron intake through foods high in iron or supplements.
Melatonin
Melatonin is a hormone produced naturally by your brain when it gets dark at night. It helps your body to fall asleep at night. It also helps to maintain your body clock from day to day.
The Therapeutic Goods Administration has not approved melatonin for use by typically developing children. But if your child is aged over 2 years, is autistic or has attention deficit hyperactivity disorder (ADHD) or low vision or blindness, and also has persistent sleep problems or trouble falling asleep and waking up in the morning, your child’s doctor might prescribe melatonin.
If your child is taking melatonin, they need to be settled and ready for bed before having their nightly dose. This is because melatonin usually works within 30-60 minutes. You shouldn’t give melatonin to your child except under direct medical advice and supervision.
Sedative medicines
Sedative medicines include Vallergan and Phenergan. Your child should take sedative medicines only under the supervision of your doctor.
These medicines aren’t recommended for children aged under 2 years. They can cause side effects like irritability, hyperactivity, challenging behaviour and daytime drowsiness in some children.
Sedative medicines are very unlikely to help with your child’s sleep problems unless your child uses them in combination with strategies focused on their bedtime routine.
Sleeping tablets
Sleeping tablets – for example, benzodiazepines – are sometimes prescribed for adults with sleep problems, but their effects in children haven’t been studied enough. In rare situations your doctor might prescribe a sleeping tablet for your child under careful medical supervision and usually only for a limited time.
Some sleeping tablets can be addictive. Also, it’s never safe to give your child medicine prescribed for someone else.
Other prescription medicines
If your child is autistic or has ADHD, behaviour disorders, developmental delay or a condition like cerebral palsy and is also sleeping poorly, discuss this with your doctor. The doctor might be able to prescribe additional medicines for your child’s sleep problems.
