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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
PubMed

Insights

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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