![]() There is inadequate information about the short-term and long-term tolerability, safety, and efficacy of sleep promoting medications and products in youth. Although there is no official approval, indication, or dosing guidelines for their use in children and adolescents, off-label treatment of sleep disturbances with over-the-counter and prescription medications are common. There is even less clarity for medications targeting sleep and circadian rhythms. The use of medications prescribed for adult depression in youth is controversial with concerns of modest therapeutic effects and higher risks for side effects, leading to questionable overall benefits-to-risk ratios. ![]() Furthermore, residual sleep problems after depression remission increase the risk of relapse, and treating sleep disturbances in youths can improve depression. For instance, it is suspected that medications prescribed for depression may not be better than placebo in patients who also have sleep disturbances. These sleep problems can interfere with antidepressant response to standard treatments. Sleep disturbances are estimated to affect 66% to 72% of children and adolescents with depression, and sleep loss was found to predict higher risks of depression in young Canadians. Yet, little is known about how sleep disturbances co-occurring with depression are addressed in current pedopsychiatric practice. Poor sleep has been linked to worse and more recurrent depression, as well as increased suicidal ideation in adolescents. Suicide is one of the leading cause of death among Canadian adolescents, and rates of suicide are increasing in this age group. In childhood and adolescence-onset depression, the risk of recurrence is high, about 50 to 70% within 5 years, and persisting depression is associated with worse suicidality. A survey of Canadians aged 15 to 24 years indicated that about 11% have experienced depression in their lifetime, and 7% reported depression in the previous year. Its prevalence increases in the early teens, more so in girls than boys. Pediatric depression is characterized by prolonged or recurrent sadness or irritability, markedly diminished interest or pleasure in activities, decrease or increase in appetite, feelings of restlessness or being slowed down, poor memory and concentration, feelings of worthlessness and guilt, recurrent thoughts of death, as well as sleep disturbances. This developmental period also marks the onset of mood disorders for many individuals. The Creative Commons Public Domain Dedication waiver ( ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.Ĭhanges in sleep and biological rhythms emerge during childhood and adolescence. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. ![]() The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made.
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