The document describes diagnostic tools for use before treatment initiation and provides recommendations for comprehensive management. The treatment of insomnia begins with sleep hygiene measures and personalized cognitive-behavioral therapies. In maintenance insomnia, if these are not sufficient, pediatric prolonged-release melatonin (PedPRM) is recommended as the first-line drug, starting with a dose of 2mg/day and adjusting it to up to 10mg/day as needed. If the problems persist, alimemazine, risperidone or clonidine can be added, in that order, in a stepwise fashion. For early insomnia, immediate-release melatonin (IRM) is recommended, starting with a dose of 5mg/day and reducing it to up to 2mg/day if it is effective or increasing it to up to 7mg/day otherwise, or else PedPRM. The dosage should be reevaluated periodically in regular follow-up visits using sleep diaries.
Arboledas et al. (Sun,) studied this question.