European expert guidance on management of sleep onset insomnia and melatonin use in typically developing children
European expert group · 2024 · Europe
Source and licence
- Authors
- Oliviero Bruni, Maria Breda, Lino Nobili et al.
- Title
- European expert guidance on management of sleep onset insomnia and melatonin use in typically developing children
- Journal
- European Journal of Pediatrics, 2024
- Licence
- CC BY 4.0
- Changes
- Verbatim excerpts; formatting adapted
Full text retrieved 2026-10-27 from Europe PMC · PMC11192690
Licence statement of the original publication
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Recommendations
We found no explicitly labelled recommendations in this publication; its recommendations are in the running text of the original.
Abstract
Sleeping problems are prevalent among children and adolescents, often leading to frequent consultations with pediatricians. While cognitive-behavioral therapy has shown effectiveness, especially in the short term, there is a lack of globally endorsed guidelines for the use of pharmaceuticals or over-the-counter remedies in managing sleep onset insomnia. An expert panel of pediatric sleep specialists and chronobiologists met in October 2023 to develop practical recommendations for pediatricians on the management of sleep onset insomnia in typically developing children. When sleep onset insomnia is present in otherwise healthy children, the management should follow a stepwise approach. Practical sleep hygiene indications and adaptive bedtime routine, followed by behavioral therapies, must be the first step. When these measures are not effective, low-dose melatonin, administered 30–60 min before bedtime, might be helpful in children over 2 years old. Melatonin use should be monitored by pediatricians to evaluate the efficacy as well as the presence of adverse effects.
Conclusion: Low-dose melatonin is a useful strategy for managing sleep onset insomnia in healthy children who have not improved or have responded insufficiently to sleep hygiene and behavioral interventions.
Supplementary Information: The online version contains supplementary material available at 10.1007/s00431-024-05556-w.
Contents of the original publication
The section headings of the original.
- Introduction and problem statement
- The role of melatonin in management of sleep onset insomnia in children
- Methods
- Selection of the experts
- Nominal group technique
- Recommendations
- Expert advices
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