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Vol. 59. Núm. 3.
Páginas 239-245 (septiembre 2003)
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Vol. 59. Núm. 3.
Páginas 239-245 (septiembre 2003)
Acceso a texto completo
Tratamiento del insomnio en niños: aspectos farmacológicos
Treatment Of Insomnia In Children: Pharmacological Aspects
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24285
M.a A. Idiazábal Alecha
Autor para correspondencia
mariannf@eresmas.com

Correspondencia: Clínica Nuestra Señora del Pilar. Balmes, 271. 08024 Barcelona. España
, E. Estivill Sancho
Unidad de Sueño. Institut Universitari Dexeus. Barcelona. España
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En los últimos años se está produciendo un progresivo interés por los temas relacionados con el sueño en la infancia. La mayoría de fármacos utilizados para el tratamiento del insomnio en los adultos no se recomiendan en niños y, a pesar de ello, el 56 % de los pediatras utilizan medicación para tratar los problemas de sueño en la infancia. Este trabajo revisa las diferentes causas del insomnio en niños desde el nacimiento hasta la edad escolar y sus diferentes opciones terapéuticas, tanto farmacológicas como conductuales. Así mismo, se evalúan los métodos terapéuticos que se han mostrado más efectivos en los diferentes tipos de insomnio. Los hipnóticos más utilizados para el tratamiento del insomnio son las benzodiazepinas y los hipnóticos no benzodiacepínicos como la imidazopiridina, la pirazolopirimidina y la ciclopirrolona. Los estudios sobre el tratamiento del insomnio con melatonina son escasos, aunque diferentes trabajos sugieren que es útil y relativamente segura en el tratamiento del insomnio en niños en edad escolar

Ante un niño con insomnio, lo primero que debe hacerse es obtener información sobre las características de su insomnio y estudiar las circunstancias ambientales que rodean al niño y a su familia. Una vez descartada una causa orgánica, el tratamiento debería basarse en proporcionar información a los padres sobre la fisiología del sueño y en programas de entrenamiento a padres sobre la higiene de sueño y la adquisición del hábito del sueño. Cuando se deba recurrir al tratamiento farmacológico, éste deberá ser seleccionado de forma cuidadosa y utilizando las mínimas dosis efectivas. La melatonina parece presentar un futuro prometedor en el tratamiento del insomnio en niños sanos y en niños con trastornos neurológicos

Palabras clave:
Insomnio
Niños
Hipnóticos

In the last few years topics related to sleep in children have aroused increased interest. Most hypnotic drugs and sedatives used to treat adult insomnia are not recommended in children. Even so, 56 % of pediatricians use medication to treat childhood sleep disorders. We review the different causes of insomnia in children from birth to school age. The various therapeutic options are discussed and the therapeutic methods that have been demonstrated to be most effective in the various types of insomnia. The most frequent hypnotic drugs used in insomnia treatment are benzodiazepines and non-benzodiazepine hypnotics such as imidazopyridine, pyrazolopyrimidine and cyclopyrrolone. Few studies have been published on the use of melatonin in insomnia although several reports suggest that is useful and relatively safe in the treatment of insomnia in school-aged children

In children with insomnia, pediatricians should first of all obtain information about the characteristics of insomnia and the environmental characteristics surrounding the child and his/her family. Once an organic cause has been ruled out, treatment should be based on informing the parents about sleep physiology and on training them in sleep hygiene and the acquisition of sleep habits. When pharmacological treatment is required, it should be carefully selected using the smallest effective doses. Melatonin seems to have a promising future in insomnia treatment in healthy children and in those with neurological disorders

Key words:
Insomnia
Children
Hypnotics
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