P087 Pharmacotherapy and prescribing practices for paediatric insomnia

Abstract Background Paediatric insomnia is common, with prevalence estimate ranging from 2-36%, with up to 86% of patients with neurodevelopmental disability effected. It is associated with lower quality of life and increased risk of poor developmental and health outcomes. Currently there is no pharmacotherapy approved for treatment of insomnia in the paediatric population. This scoping review aims to summarise the current literature available for efficacy, safety and prescribing practices for pharmacological agents used to treat insomnia in the paediatric population. Methods Searches were conducted in MEDLINE, Cochrane Database of Systematic Reviews, and Pubmed using terms for antihistamines, alpha-adrenergic agonists, benzodiazepines, chloral hydrate, melatonin and nonbenzodiazepine hypnotics. Studies were limited to those undergone peer review, available online and published in English. Progress to date 1538 abstracts reviewed for inclusion, grouped and critically appraised according to drug class category. Antihistamines 4 papers included, 3 demonstrating antihistamines as most common medication prescribed for insomnia. Benzodiazepines 11 papers included with no randomised controlled trials. 6 papers demonstrating common prescription by General Paediatricians and Psychiatrists, and 3 papers showing improvement in parental perceived sleep quality in patients with neurodevelopmental disability. Chloral hydrate No papers meeting inclusion criteria Clonidine 14 papers, with 7 describing prescribing practices and common usage for insomnia in neurodiverse populations and5 case series showing improved sleep latency and reduced frequency of night waking. Melatonin and Nonbenzodiazepine hypnotics Pending review Intended impact To identify current prescribing practices and identify areas of further research to guide clinicians in prescribing pharmacotherapy to treat paediatric insomnia.