Paediatric sleep medicine is a relatively new but important and rapidly growing field. It is increasingly recognised that many “adult” sleep disorders begin in childhood where the consequences of missed diagnoses can be devastating. Adequate training of all health care professionals and careful eliciting of symptoms remains the first step in ensuring accurate and timely diagnoses. Although behavioural approaches play a huge role in paediatric sleep medicine, at times severe sleep disorders also require pharmacological treatments. However, the evidence base for these is weak, and currently treatments of conditions including insomnia, narcolepsy and restless legs syndrome in childhood still rely on hopeful extrapolation from adult data. A growth in randomised controlled trials over the last 5 years is encouraging; trial methodologies are also improving. International working groups and multicentre trials will increasingly be needed to evaluate the new technologies and pharmacological treatments that are emerging.
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Competing interests: The author is co-lead applicant on the ongoing MENDS Health Technologies Assessment funded trial of melatonin in developmental disabilities. Alliance Pharmaceuticals have supported this study through development of a CTA and supply of melatonin and placebo. The author has given independent educational lectures, received honoraria and attended events sponsored by Janssen-Cilag and UCB Pharma.