American Academy of Sleep Medicine

View all recommendations from this society

Released December 2, 2014

Don’t prescribe medication to treat childhood insomnia, which usually arises from parent-child interactions and responds to behavioral intervention.

No medications are approved by the US Food and Drug Administration for the treatment of pediatric insomnia. As childhood insomnia usually arises due to parent-child interactions, treatment should involve efforts to improve relevant parent and child behavior, establish better sleep hygiene and manage expectations. Basic environmental, scheduling, sleep practice, and physiological features should be optimized before hypnotic use is considered for children. When necessary, hypnotics should be used short term, with caution and close monitoring for efficacy and side effects. Some children with significant developmental delay or cognitive impairment may not respond to behavioral management and may benefit from judicious use of hypnotics.

These items are provided solely for informational purposes and are not intended as a substitute for consultation with a medical professional. Patients with any specific questions about the items on this list or their individual situation should consult their physician.

How The List Was Created

The Executive Committee of the American Academy of Sleep Medicine developed 21 candidate recommendations for ways in which medical waste could be minimized while care for patients with sleep disorders is improved. Members of the Executive Committee then voted to assign priorities to each, and the top five were selected. Final wording of the five statements were approved by the full Board of Directors of the American Academy of Sleep Medicine. The Secretary/Treasurer and research staff of the American Academy of Sleep Medicine developed rationale and references for each recommendation. The final statements, explanations and citations were approved by a final vote of the Board of Directors.

The AASM disclosure and conflict of interest policy can be found at


Owens JA, Babcock D, Blumer J, Chervin R, Ferber R, Goetting M, Glaze D, Ivanenko A, Mindell J, Rappley M, Rosen C, Sheldon S. The use of pharmacotherapy in the treatment of pediatric insomnia in primary care: rational approaches. A consensus meeting summary. J Clin Sleep Med. 2005 Jan 15;1(1):49-59.

Owens JA, Mindell JA. Pediatric Insomnia. Pediatr Clin N Am. 2011 Jun;58(3):555-69.

Sheldon SH, Ferber R, Kryger MH, Gozal D, eds. Principles and Practice of Pediatric Sleep Medicine: second edition. London: Elsevier Saunders; 2012.