38: Caregiver Attitudes and Usage of Sleep-Promoting Medication in Children
Bibliographic record
Abstract
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.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.005 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".