Whatever Gets You Through The Night

Thinking of investing in commodities—coffee beans to be exact? Yeah, you're trying to corner the market on coffee, because your kid's not sleeping which means that you're not sleeping, either. If it weren't for several cups of very strong coffee, you'd never make it through the day, because you're sure not making it through the night.

Common Component

You may have been too tired to notice, but one out of every four of the other parents you know is going through the same thing. Maybe not exactly the same thing, there are many different types of sleep disorders, but they all share one common component: exhausted parents! After trying various methods suggested by parenting books and magazines, you've thrown up your hands in despair. It's time to visit your child's physician.

Your pediatrician is going to decide your child's treatment in part by how desperate you seem. If things seem very urgent to him, he may decide to grant you and your child some short-term relief with prescription medication. The three most popular medications prescribed by doctors for ITSD (infant toddler sleep disturbance) are antihistamines in the form of benadryl, after which comes chloral hydrate—famous as the main ingredient in the infamous Mickey Finn, and benzodiazepine, though melatonin is gaining on these choices in terms of safety and efficacy. This article focuses on benzodiazepines.

Benzodiazepines such as Klonopin (clonazepam) and ProSom (estazolam) have the distinction of being one of the most commonly prescribed medications of any kind, any where in the world. Doctors use benzodiazepines to treat insomnia, anxiety, and alcohol or sedative withdrawal. As is always the case with young children, there is a difficulty in obtaining clinical data through research trials. So no one knows the long-term effects of this medication on infants and toddlers.

Night Terrors

Still, doctors often prescribe a low dose of benzodiazepine to toddlers who have trouble with sleep onset (settling in at bedtime) and night wakefulness. But in general, it's best to reserve benzodiazepine for children who are experiencing parasomnias, which include sleepwalking and night terrors. Diazepam, administered as a low dose just before bedtime gives significant relief from these semi-wakeful states. The theory is that this medication may suppress slow wave sleep and this eliminates the disturbance.

So, what's the downside? Benzodiazepines have a whole slew of well-known side effects including drowsiness the next day, the gradual decrease of cognitive and performance abilities, changes in sleep architecture (types of sleep states experienced), and dependence. It also carries a high risk for relapse once the drug is discontinued. Because of these known side effects plus the lack of knowledge relating to the effects of the drug on a child's developing nervous system, the use of benzodiazepines is discouraged by the larger medical community.