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

Eur Child Adolesc Psychiatry (2005)

14:3440 DOI 10.1007/s00787-005-0424-4 ORIGINAL CONTRIBUTIONAntonina IngrassiaJeremy Turk The use of clonidine for severe and

intractable sleep problems in children

with neurodevelopmental disordersA case serieswith 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. Key words clomidine

neurodevelopmental disorder

sleep problems ADHDAccepted: 17 August 2004A. Ingrassia, MB, BS (HONS) ()

South West London & St. Georges Mental

Health NHS TrustAdolescent Assertive Outreach Team

ASH CorridorSpringfield HospitalTooting, London SW17 7DJ, UKTel.: +44-20/86826609E-Mail: [email protected]. Turk MD, MB, BS, BSc(HONS)

Dept. of Clinical Developmental Sciences

St.Georges Hospital Medical School

University of London, UK 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 childrenIntroductionThe problem of sleep disorders is a widespread and distressing one [19, 20]. In the Isle of Wight survey, 1520 %

of 10- to 12-year-olds were reported as having difficulties

of this nature [22]. Higher rates are described in other

studies [11, 13]. There is a strong association between

night-time problems and day-time behavioural difficulties [19, 28], as well as maternal stress and depression[33], family discord and parental separation [3].

In children with developmental disorders the prevalence of sleep problems is greater and symptoms are

more severe. A study comparing sleep problems in children attending mainstream primary schools with those

experienced by pupils at special schools showed that a

significantly higher proportion of the children in special

schools suffered with dyssomnias and features associated with sleep apnoea [17].Furthermore,epilepsy coexists with many developmental disorders and it is an important contributing factor to the sleep problems [24].The childs sleeping difficulties can have a major impact on family life, placing an added burden on parents

already coping in exceptional circumstances. Failure to

improve spontaneously, as is often the case in normal

children where sleeping difficulties may represent just a

developmental stage, can lead to further psychological

stress, disappointment and frustration. Additionally,

very often, sleep disturbances in children are significantly associated with disturbances to family sleep [4].

In a study on behavioural treatment...