Sleep disorders can be serious, but differentiating between a real medical problem and a child who may be just cranky, or not wanting to go to sleep when they are supposed to is a different matter altogether.
According to a study by the Canadian Paediatric Society published in June of 2015, the parents of 350 children between the ages of one and 10 years old were surveyed who came into the emergency department. The parents were asked if their children had trouble sleeping, and if they medicated them.
CBC News reported on Thursday the percentage of children being medicated was fairly high. “It’s pretty high, 70 percent,” said Wendy Hall, a nursing professor and a University of British Columbia researcher. (She was referring to the findings of the study claiming 70 percent of children have a sleep disorder).
Hall did add that the high numbers may not reflect the overall population, and I’m glad she added that bit of information because if this were true, that would mean that seven out of every 10 kids is walking around stumbling into walls because they are sleep deprived.
We need to remember that chronic physical illness, such as asthma, a psychiatric disorder (eg, attention deficit hyperactivity disorder) or a learning disability can leave children prone to problems with sleep, and quite often, general practitioners just might not recognise an underlying sleep disorder.
“We know that children with sleep problems are a bit more clumsy because they are sleep deprived and also don’t have a strong immune system,” she said, adding, “So it’s conceivable there would be a a higher proportion of children who are otherwise healthy going to the emergency department.”
Use of over-the-counter medications is worrisome
The one thing that stands out in the study is the number of children, a whopping 30 percent, that are medicated with over-the-counter melatonin or Tylenol. Hall was alarmed by this. (Let’s keep in mind the mean age of the children was eight years old).
According to the study, the three most common sleep problems experienced repeatedly by children were bedtime resistance/delayed sleep onset, frequent night awakenings, and difficulty falling asleep or returning to sleep.
For those children who exhibited resistance to going to bed, and that number amounted to almost 50 percent, 8.6 percent were given medication to get them to sleep. Of the 32 percent who woke during the night, or had difficulty falling asleep, 21.4 percent were medicated with OTC medications on at least one occasion, while 4.6 percent were given a doctor prescribed medication.
Melatonin and Tylenol as a sleep aid – Is this good?
The Ontario study found that the two most popular OTC medications used by parents to drug their children to sleep were melatonin and Tylenol. Almost 20 percent of children in the survey were given melatonin while 7.2 percent were given Tylenol PM.
Melatonin is a hormone produced in the body, and it plays an important role in regulating our circadian rhythms and other biological processes. In a paper published in the Journal of Paediatrics and Child Health in February 2015, Professor David Kennaway, Head of the Circadian Physiology Laboratory at the University of Adelaide’s Robinson Research Institute, warned that providing melatonin supplements to children as a sleep aid could result in serious side-effects as they got older.
Kennaway also pointed out that the U.S. is the only country where melatonin is completely unregulated. “It’s considered to be a “dietary supplement,” not a regulated drug, and is therefore readily available,” he says. He also said that in Australia, “melatonin is registered as a treatment for primary insomnia only for people aged 55 years and over, but it’s easily prescribed as an “off-label” treatment for sleep disorders for children.”
While Hall says researchers don;t know the long-term effects of melatonin, Professor Kennaway cites extensive evidence pointing to the adverse effects of melatonin to multiple systems, such as the cardiovascular, immune and metabolic systems, as well as reproduction in animals.
Tylenol, also known as acetaminophen, paracetamol, Panadol and Mapap, is found in over 100 medications, from Alka-Seltzer to Percocet and Excedrin. It is an OTC pain reliever used for mild to moderate headaches, muscle aches, backaches, sore throats and other cold symptoms, menstrual cramps, toothaches and reactions to shots.
When Benadryl is added to Tylenol, you end up with Tylenol PM, a sleep aid sold around the world.
Children should never be given the adult dose of Tylenol because a child’s dosage is based on age and weight. Believe me, an incorrect dose or what is called an overdose can be lethal in a child. In 2013, the FDA and CDC published a warning on three potentially lethal skin disorders associated with acetaminophen, Stevens-Johnson syndrome, toxic epidermal necrolysis, and acute generalized exanthematous pustulosis.
Because of this warning, concentrated forms and drops of acetaminophen for children are no longer being produced in the United States. For those parents who may not know, acetaminophen is also the most common cause of acute hepatic failure and the second most common cause of liver failure requiring a transplant.
Here is a New Year’s resolution all parents should try really hard to keep going into 2016: Lay off medicating your children because you may end up putting them at risk for serious health problems. If you really believe your child may have a sleep disorder, take him or her to a qualified physician in the field of sleep disorders.
