Pediatrics |

Physician Prescribing Habits of Sleep-Promoting Medications for Children and Adolescents in Southwestern Ontario, Canada FREE TO VIEW

Dirk Bock; Elizabeth Roach-Fox; Jamie Seabrook; Doreen Matsui; Michael Rieder, PhD
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Children's Hospital, London Health Sciences Centre, University of Western Ontario, London, ON, Canada

Chest. 2014;146(4_MeetingAbstracts):711A. doi:10.1378/chest.1994656
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SESSION TITLE: Pediatric Sleep Posters

SESSION TYPE: Original Investigation Poster

PRESENTED ON: Wednesday, October 29, 2014 at 01:30 PM - 02:30 PM

PURPOSE: Despite minimal data and limited indications for the use of sleep-promoting medications in children and adolescents, recent research indicates that pharmacotherapy may be commonly used to treat Pediatric insomnia. Canadian data is lacking. This pilot study aimed to determine physicians' views on prescribing habits of sleep-promoting over-the-counter (OTC) and prescription (Rx) medications for children and adolescents in southwestern Ontario.

METHODS: A modified 26-item version of the "Pediatric Sleep Medication Survey", originally developed by Judith Owens and colleagues, was sent to 100 pediatricians and a random sample of 421 family physicians (GPs) practicing in southwestern Ontario. Physicians were contacted by email (where available) or mail, and had the option of completing a paper- or web-based survey. Two mail-outs were sent 6 weeks apart, a third one 3 months later.

RESULTS: 77 surveys were returned (response rate 15%), and 67 were sufficiently complete for analysis. 61 respondents indicated their speciality (28 pediatrics, 33 GPs; 48% female), of which only 19.7% had received formal training on diagnosing and treating sleep disorders. 49.9% of GPs and 33% of Pediatricians in our sample regularly screen children for sleep problems during well-child visits. 68.9% have recommended OTC, and 61.4% Rx medications for children with sleep problems in the past. The 3 most common circumstances and sleep disorders, in which OTC or Rx medications were recommended for sleep problems, were mood disorders, developmental delay, and ADHD (by 56.1%, 40.3, 39.4%), and insomnia, bedtime struggles/delayed sleep onset, and circadian rhythm disorders (by 51.5, 47.8, 27.7% of physicians), respectively. 29.7% of physicians recommended either one to otherwise healthy children with sleep problems. Melatonin and antihistamines (by 68.9 and 29.2% of respondents), and antidepressants and clonidine (by 36.8 and 26.3%) were the two most commonly recommended OTC and Rx medications, respectively.

CONCLUSIONS: Despite very limited indications, pharmacotherapy to treat Pediatric sleep problems is commonly used by physicians in our sample, even for otherwise healthy children. The low survey response rate may limit the generalizability of our findings.

CLINICAL IMPLICATIONS: Canadian-wide data on the use of pharmacotherapy to treat, and guidelines for managing Pediatric sleep disorders are urgently needed, along with Pediatric data on sleep medication safety and dosing.

DISCLOSURE: The following authors have nothing to disclose: Dirk Bock, Elizabeth Roach-Fox, Jamie Seabrook, Doreen Matsui, Michael Rieder

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