The use of clonidine for severe and intractable sleep problems in children with neurodevelopmental disorders - A case series

West London Mental Health NHS Trust, Londinium, England, United Kingdom
European Child & Adolescent Psychiatry (Impact Factor: 3.55). 03/2005; 14(1):34-40. DOI: 10.1007/s00787-005-0424-4
Source: PubMed

ABSTRACT This paper reports on the use of clonidine for the treatment of severe sleep problems associated with behavioural difficulties in children with neurodevelopmental disabilities. Data were obtained from reviewing the case notes of a series of six children with neurodevelopmental disorders of different nature and severity, presenting with problematic sleep. All children in this group showed maintained improvements in their sleep pattern following the use of clonidine with only mild side-effects reported.

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    ABSTRACT: Background Psychopharmacological prescribing of clonidine has been described in Australia and in the United States but not in Europe. This study explores UK clinician experience of clonidine ‘off label’ in treating paediatric sleep problems in the context of a paucity of evidence for its use. Methods Survey of UK Child and Adolescent Psychiatrists (CAPs) and specialist Paediatricians. ResultsOf 389 respondents (30% Paediatricians, 70% CAPs), 172 prescribed clonidine and 85 having used it for treating sleep. Treatment targets were sleep onset, night waking and nonspecific sleep problems, and carer respite, in patients with significant coexisting neurological and neurodevelopmental disorders. Most used clonidine as a second line medication after trying nonpharmacological approaches. The majority reported initial effectiveness, and adverse effects were mild or transient. Issues of reducing long-term effectiveness, drug tolerance and considerable differences in dosing regimes were identified. Conclusions Clonidine use appears less widespread in the United Kingdom than reported elsewhere. It is seen as a potentially effective and safe intervention but this study highlights the need for good quality RCT evidence for the most effective use of clonidine in paediatric sleep disorders.
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