454 - Trends in Medication Prescriptions for Pediatric Insomnia and Sleep Disturbances in Outpatient Settings: Findings from the 2006-2016 National Ambulatory Care Survey

Saturday, April 29, 2023

3:30 PM – 6:00 PM ET

Poster Number: 454
Publication Number: 454.216

Andreas A. Teferra, Nationwide Children's Hospital, Columbus, OH, United States; Mattina A. Davenport, Nationwide Children's Hospital, Columbus, OH, United States; Maninder Kalra, Nationwide Children's Hospital, Columbus, OH, United States; Deena J. Chisolm, Nationwide Children's Hospital, Columbus, OH, United States; Kelly J. Kelleher, Nationwide Children's Hospital, Columbus, OH, United States

Presenting Author(s)

MD

Mattina A. Davenport, PhD (she/her/hers)

Nationwide Children's Hospital
Columbus, Ohio, United States

Co-Author(s)

AT

Andreas A. Teferra, PhD, MS (he/him/his)

Research Scientist
Nationwide Children's Hospital
Columbus, Ohio, United States

Background: The prevalence of insomnia symptoms ranges from 20% to 25% in children and 25% to 35% among adolescents. Although there are no medications that are labeled for use for insomnia in pediatric patients, pharmacologic management remains common.

Objective: The study examined trends in medication prescriptions for children and adolescents (≤ 21 years) with outpatient visits for sleep disturbances or insomnia diagnoses.

Design/Methods: We conducted a pooled cross-sectional analysis of the 2006 to 2016 National Ambulatory care survey. Survey-weighted analysis stratified by age, sex, race/ethnicity, provider status, and prescription type as well as multivariable logistic regression models were carried out.

Results: The number of office visits with sleep disturbances or insomnia diagnosis rose from 1.3 million in 2006 to 2.2 million in 2016 (p = 0.014). Among these, prescriptions of medications rose from 1 million in the period between 2006-2009 to 2.2 million in 2014-2016 (p = 0.012). Notably, prescriptions among 11-21-year-olds increased from 545,000 in 2006-2009 to 1.7 million in 2014-2015 (p = 0.032). Prescriptions also increased significantly among Non-Hispanic White children and adolescents: 790,000 in 2006-2009 to 2 million in 2014-2016 (p = 0.002). Prescriptions by primary care providers increased from 780,000 in 2006-2009 to 1.2 million in 2014-2016 (p = 0.075). The use of prescription-only medications increased from 700,000 in 2006-2009 to 1.2 million in 2014-2016, although this difference was not statically significant (p = 0.2). However, there were no meaningful changes in non-prescription (OTC) medications over time. Multivariable regression models found that the odds of medication prescription significantly increased across year of survey and age. The odds of prescription were also significantly higher among NH Whites compared to racially minoritized groups.

Conclusion(s): Despite the lack of concrete guidance and limited data on the effectiveness of pharmacotherapy, the findings suggest an increasing trend and demographic variation in prescriptions of sleep medications among children and adolescents who present to outpatient settings with sleep disturbances or an insomnia diagnosis.