38: Caregiver Attitudes and Usage of Sleep-Promoting Medication in Children
Notice bibliographique
Résumé
Pediatric insomnia affects an estimated 30% to 35% of children, and is a common reason for parental concern. Despite minimal safety data and limited indications, recent evidence indicates that physicians frequently recommend medication for children with sleep problems. Canadian data on the frequency and type of medication used, and on parental attitudes toward sleep-promoting medication in children are lacking. To characterize parental attitudes and the usage of sleep-promoting over-the-counter (OTC) and prescription (RX) medications for children. In this prospective, pilot survey study, caregivers presenting with their children (birth to 18 years) to a pediatric emergency department at a tertiary care centre between March 2012 and April 2014 completed a 20-item modified version of the Pediatric Sleep Medication Survey. This instrument was originally developed by Judith Owens and colleagues to assess physician prescribing habits of sleep medications in children. Three hundred fifty surveys were distributed, of which 346 surveys were sufficiently complete to be analyzed. Children were on average eight years old (SD±5). 49.1% were female, and 73% Caucasian. The three most common sleep problems experienced repeatedly by children in our sample were bedtime resistance/delayed sleep onset (43.5%, with 8.6% having received medication to treat this), frequent night awakenings (32%), and difficulty falling asleep or returning to sleep after awakening. 21.4% of children had received an OTC sleep-promoting medication on at least one occasion, and 4.6% at least one RX sleep-promoting medication. In young children, pain reliever combinations (e.g. Tylenol PM) were the most commonly used OTC medications (7.2%) to facilitate sleep. In children 6 to 18 years of age, melatonin was the most frequently cited OTC medication (19.3%) of children in our sample, used at least once between the ages of 6 to 18 years. Benzodiazepines (2%) were the most frequently reported RX medications used for sleep in nearly all ages. Many parents endorsed that medication for sleep problems should be used only if other treatments have failed (53.4%), or in combination with behavioural techniques (27.4%). Some parents (18.9%) also felt that giving sleep-promoting medication was appropriate in order to provide respite for the family. Concern regarding short- or long-term side effects (65.1%) and development of tolerance or habituation (53.7%) were the most frequently cited reasons against sleep medication usage. Over-the-counter and prescription medications were commonly used to treat sleep problems for children in our sample. 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. Counselling for families should focus on emphasizing behavioural strategies and discouraging pharmacotherapy for managing pediatric insomnia.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,005 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,001 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,001 | 0,000 |
| Communication savante | 0,001 | 0,000 |
| Science ouverte | 0,000 | 0,001 |
| Intégrité de la recherche | 0,000 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,002 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».