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Pediatric Insomnia
Rayan Kteish1, Mathew Ednick1, Catherine Kier1
1Stony Brook Children's Hospital, Renaissance School of Medicine, Stony Brook, New York.
Pediatrics in Review
|December 31, 2025
Summary
Pediatric insomnia, difficulty sleeping in children, is common, especially in those with autism spectrum disorder (ASD) or attention-deficit hyperactivity disorder (ADHD). Cognitive behavioral therapy for insomnia (CBT-I) is the most effective treatment.
Area of Science:
- Pediatrics
- Sleep Medicine
- Child Psychology
Background:
- Pediatric insomnia significantly impacts children's well-being, characterized by difficulties initiating or maintaining sleep.
- Insomnia prevalence is higher in children with autism spectrum disorder (ASD) and attention-deficit hyperactivity disorder (ADHD).
- Common subtypes include behavioral insomnia and psychophysiological insomnia.
Purpose of the Study:
- To highlight the importance of pediatrician familiarity with pediatric insomnia diagnosis and management.
- To emphasize the need to rule out underlying medical or psychological conditions mimicking insomnia.
- To review current and potential treatment strategies for pediatric insomnia.
Main Methods:
- Clinical review of pediatric insomnia subtypes, prevalence, and associated conditions.
- Evaluation of current diagnostic challenges and management approaches for pediatricians.
- Assessment of evidence for cognitive behavioral therapy for insomnia (CBT-I) and pharmacologic options like melatonin.
Main Results:
- Pediatric insomnia diagnosis can be challenging due to subtle clinical signs.
- Cognitive behavioral therapy for insomnia (CBT-I) is the leading evidence-based treatment.
- Melatonin shows promise for children with ASD or ADHD, but further research on other medications is needed.
Conclusions:
- Pediatricians must be vigilant in diagnosing and managing insomnia, considering comorbidities.
- Early intervention is critical to prevent chronic insomnia and its negative effects on mental health.
- CBT-I is the first-line treatment, with melatonin as a potential adjunct for specific populations.
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