American Academy of Sleep Medicine

View all recommendations from this society

Released December 2, 2014; Updated December 21, 2021

Don’t prescribe medications to treat childhood insomnia unless behavioral interventions are unsuccessful or not indicated.

Childhood insomnia often arises from environmental factors and is well-treated with education of the parents and child about establishing good sleep hygiene practices, wind-down routines, and adequate and appropriate sleep schedules. This approach is usually effective for insomnia symptoms in typically developing younger children. Behavioral interventions are also effective and long-lasting for insomnia in school- or teen-aged children with
other medical, psychological, or neurodevelopmental disorders. No medications are approved by the US Food and Drug Administration for the treatment of childhood insomnia. Nonetheless, some children with significant developmental delay, cognitive impairment, or other medical/psychiatric disorders might not respond to behavioral therapies alone, so they may benefit from judicious use of sleep-promoting medications, which should be used with caution and close monitoring for efficacy and side effects.

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 in 2014. 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 list was reviewed and updated by the Guidelines Advisory Panel with final revisions approved by the Executive Committee in 2021.

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.