A Review of the Use of Clonidine as a Sleep Aid in the Child and Adolescent Population

Currently, there are no FDA-approved medications for treatment of insomnia in children and adolescents. Clonidine has been increasingly used by general pediatricians and child and adolescent psychiatrists off-label as a sleep aid in children for many years. The mechanism by which clonidine aids sleep is unclear, but most studies suggest that the decrease in norepinephrine via negative feedback by agonism of α2 receptors causes an increase in REM sleep. Several studies have documented the efficacy of clonidine as a sleep aid in children with and without ADHD, autism spectrum disorders, developmental delays, and genetic syndromes. The most commonly reported side effects from clonidine include daytime sedation, drowsiness, dizziness, fatigue, headaches, hypotension, and bradycardia. A small number of clonidine overdoses result in fatality and there is some evidence that the trend of overdose on clonidine may be on the rise. However, generally, clonidine is well-tolerated in children and has been efficacious in treating pediatric insomnia. More research is needed regarding the long-term use of clonidine as a sleep aid in the pediatric population. © The Author(s) 2014.