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Pharmacotherapeutic management of sleep disorders in children with neurodevelopmental disorders

机译：神经发育障碍儿童睡眠障碍的药物治疗管理

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Introduction: Sleep disturbances are highly prevalent in children with neurodevelopmental disabilities. Without appropriate treatment, sleep disorders can become chronic and last for many years. However, there are no sleep medications approved by the United States Food and Drug Administration and only one has been approved by the European Medicines Agency for pediatric insomnia; thus, most medications are prescribed off-label. Areas covered: In this narrative review, the authors highlight and summarize the most common drugs and supplements used for the treatment of sleep problems in children with neurodevelopmental disabilities. Recommendations are formulated regarding the use of melatonin and melatonin receptor agonists, sedating antidepressants, antipsychotics, antihistamines, gabapentin, clonidine and orexin receptor antagonists, and benzodiazepines and hypnotic benzodiazepine receptor agonists. Expert opinion: The choice of pharmacological agents and their dosage should be individualized taking into consideration multiple factors, including the severity and type of sleep problem and the associated neurological pathology. Melatonin is widely used and safe in children with neurodevelopmental conditions. Gabapentin, clonidine, trazodone, and mirtazapine hold promise but require further study. Supplements (iron, vitamin D, and 5-hydroxytryptophan) might be helpful. Due to the lack of clinical data, there is still uncertainty concerning dosing regimens and tolerability.
机译：介绍：睡眠障碍在神经发育障碍的儿童中普遍普遍。没有适当的治疗，睡眠障碍可以成为慢性，持续多年。然而，没有由美国食品和药物管理局批准的睡眠药物，只有一个已被欧洲药物批准的儿科失眠批准;因此，大多数药物被规定的标签。所涵盖的地区：在这一叙事审查中，作者突出了并总结了用于治疗神经发育障碍儿童睡眠问题的最常见的药物和补充剂。关于使用褪黑激素和褪黑激素受体激动剂，镇静抗抑郁药，抗精神病药，抗组胺药，加巴普坦，克拿尼丁和奥克森受体拮抗剂的建议，以及苯并二氮杂卓和催眠苯二氮卓受体激动剂。专家意见：考虑多种因素褪黑激素被广泛使用和安全地在具有神经发育病症的儿童中。加巴亨坦，Clonidine，Trazodone和Mirtazapine保持承诺，但需要进一步研究。补充剂（铁，维生素D和5-羟基特辛甘）可能会有所帮助。由于缺乏临床数据，仍有关于给药方案和耐受性的不确定性。

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