0747 Medications Prescribed For Sleep Problems In Children And Adolescents With Psychiatric Disorders.

Abstract

Introduction: Up to 90% of children and adolescents with a psychiatric diagnosis also suffer from sleep disorders, thus worsening their diurnal symptoms. Most of these children are prescribed medications to help them cope with their sleep difficulties. We analyzed the medical files of patients referred to the sleep clinic of a pediatric mental health hospital. Method(s): The medical charts of 401 patients diagnosed with or being evaluated for a psychiatric disorder and referred to the sleep clinic of a pediatric mental health hospital were reviewed by two judges with full access to the complete hospital file of each patient. Result(s): The mean age of patients was 8.4 +/- 4.7 years and 67% were boys. The most frequent primary diagnoses were Autism Spectrum Disorder (ASD, 39.4%) and Attention Deficit Hyperactivity Disorder (ADHD, 28.7%). A majority of patients (81.2%) was either referred by a pediatrician (42.8%) or a psychiatrist (38.4%). At intake, all diagnoses being combined, 78.5% of patients were taking melatonin, a product available over-the-counter in Canada. Antipsychotics (18.9%), antidepressants (10.7%) and clonidine (also 10.7%) were the most prescribed medications at bedtime. In ASD and ADHD more specifically, antipsychotics were the most prescribed medication at bedtime, with 23.4% and 29.6% of patients, respectively. Conclusion(s): Melatonin was reported as the most frequent sleep aid taken by patients upon their arrival at the sleep clinic but dosage and timing varied greatly, pointing toward a knowledge gap in parents, prescribers, providers and/or advisors. The use of antipsychotics at bedtime in children and adolescents is alarming, given the fact that there is no published scientific evidence to support their use.