Children’s sleep problems: sleep medicine or other strategies?

If your child is having trouble getting to sleep or staying asleep, medicine won’t necessarily fix the problem. In Australia, sleep medicines are rarely used to help children sleep because medicines can have side effects. Even herbal or ‘natural’ remedies can have side effects.

Sometimes you can make other changes to help your child sleep better. These changes include:

• introducing better sleep habits
• limiting food and drinks with caffeine.

If better sleep and eating habits aren’t helping, talk with your GP – especially if your child’s sleep problems are affecting her wellbeing, schoolwork or relationships. Also seek help if sleep problems are making your child anxious, or if they go on for more than 2-4 weeks. Each child needs individual treatment for sleep problems.

Using sleep medicines for children

For a difficult sleep problem, your doctor might prescribe a medication like melatonin or a sedative to help your child sleep.

The doctor will probably suggest your child uses the sleep medicine for a short time – days or months – in combination with behaviour strategies to improve your child’s sleep habits. Using behaviour strategies together with sleep medicines can help your child keep sleeping better when he stops taking the medicine.

If your doctor does prescribe medicine to help your child sleep, ask about the possible side effects of the medicine.

Some sleep medicines are also available 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.

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 medication.

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.

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 overall 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.

Melatonin

Melatonin is a hormone produced naturally by your brain when it gets dark at night. It helps your body fall asleep at night. It also helps maintain your body clock from day to day.

Your doctor might prescribe melatonin if your child has autism spectrum disorder (ASD) or attention deficit hyperactivity disorder (ADHD), or a visual problem including blindness. Your doctor might prescribe melatonin for your teenage child if she has trouble falling asleep and waking up in the morning.

If your child is taking melatonin, he needs to be settled and ready for bed before having his 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 medications

Sedative medications include the antihistamine drugs Vallergan and Phenergan. Your child should take sedative medications only under the supervision of your doctor.

These medications aren’t recommended for children under three years of age. They can cause side effects like crankiness, hyperactivity, challenging behaviour and daytime drowsiness in some children.

Use of a sedative medication by itself is very unlikely to help your child’s sleep problem without behaviour strategies to improve your child’s bedtime routine.

Sleeping tablets

Sleeping tablets – for example, benzodiazepines – are sometimes prescribed for adults with sleeping 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.

Note that some sleeping tablets can be addictive. Also, it’s never safe to give your child medication prescribed for someone else.

Other prescription medications

If your child has ADHD, ASD, behaviour problems, developmental delay or a medical condition – for example, cerebral palsy – and is also sleeping poorly, discuss this with your doctor. Your child’s paediatrician might be able to prescribe additional medications for your child’s sleep problems.

Sleep medicine will help in the longer term only if your child uses it along with strategies to help her learn new sleep behaviours.