Sleep Med Prescriptions Surge Among Children Post-COVID
TOPLINE:During the COVID-19 pandemic, prescriptions for hypnotic medications notably increased among children, particularly among those aged between 6 and 11 years for prolonged-release melatonin and in adolescents for Z-drugs such as zolpidem; this increase persisted until the end of the study in December 2023.METHODOLOGY:Researchers conducted a cross-sectional analysis of national dispensing data over 7 years starting in January 2016 to assess prescriptions for hypnotic medications (hydroxyzine, alimemazine, melatonin, and Z-drugs) dispensed to children aged 6-17 years in France.They analyzed over 2 million prescriptions dispensed using data extracted from a retail sales database sampling approximately 60% of retail pharmacies.Monthly prescription rates of hypnotic medications per 1000 children were analyzed before and after the onset of the pandemic in March 2020 to evaluate changes in rates and trends.TAKEAWAY:The majority of prescriptions for hypnotic medications were for hydroxyzine (53.2%) and prolonged-release melatonin available only by prescription (38.1%), with most prescriptions (60.4%) dispensed to children aged between 12 and 17 years.In January 2016, the estimated prescription rate of hypnotic medications was 1.9 per 1000 children, which increased to 6.8 per 1000 children by December 2023, with post-pandemic prescription rates surpassing expected rates by 131% (rate ratio, 2.31; 95% CI, 2.08-2.54).Post-pandemic prescription rates exceeded expected rates by 38% for hydroxyzine, 19% for alimemazine, 344% for melatonin, and 419% for Z-drugs zolpidem or zopiclone.The relative increase in prescriptions for melatonin was more significant in children aged 611 years, while the increase in prescriptions for other medications was more pronounced in those aged 1217 years.IN PRACTICE:"These increases are possibly related to children's persistently deteriorating mental health, changes in medical prescribing strategies, and unmet preexisting therapeutic needs. Treatment options should be tailored to the unique needs of this population, and support for children and families to implement adequate sleep hygiene should be enhanced. Without the latter, pharmacological options will fail to improve their sleep in a sustainable manner," the authors wrote.SOURCE:The study was led by Zaba Valtuille, MsC, from the Center of Clinical Investigations at Robert Debré University Hospital in Paris, France. It was published online on February 5, 2025, in The Journal of Pediatrics.LIMITATIONS:Individual patient-level data were not analyzed, so researchers were not able to determine whether the increase in prescription rates was due to more children being exposed or more prescriptions being dispensed per child. Sex differences in the use of hypnotic medications could not be examined due to unreliable data recording. The indications for hypnotic medication prescriptions in children, their comorbidities, or any comedications dispensed were not investigated.DISCLOSURES:This study was supported by grants from the Agence Nationale de la Recherche and Fondation de France. Two authors declared being employees of pharmaceutical company IQVIA France, while another author reported receiving travel grants from Pfizer, among others.This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.
