Medical Disclaimer
This app is a tracking and observation tool only. It is not a substitute for professional medical advice. Always consult with your GP, pediatrician, or healthcare provider regarding sleep issues and medication management. All medical decisions should be made in consultation with qualified healthcare professionals.
Second-Line Medications
When behavioral strategies and melatonin are not sufficient, specialists may consider other medications. These are typically used only under the supervision of a consultant paediatrician or child psychiatrist.
⚠️ Expert Guidance Required
The use of these medications for sleep in children is often "off-license", meaning the manufacturer hasn't specifically applied for a license for this use in children. This is common in paediatrics, but requires careful specialist monitoring and shared care agreements.
Clonidine
Alpha-2 adrenergic agonistMain Use
Sleep onset and maintenance, often with ADHD
Common Side Effects
Dry mouth, drowsiness, low blood pressure, headache. IMPORTANT: Never stop abruptly as this can cause a rapid increase in blood pressure (rebound hypertension).
Promethazine (Phenergan)
Sedating AntihistamineMain Use
Short-term sleep onset help
Common Side Effects
Morning drowsiness, blurred vision, dry mouth, constipation
Alimemazine (Vallergan)
Sedating AntihistamineMain Use
Severe sleep disturbances in children
Common Side Effects
Drowsiness, dry mouth, thickening of mucus, coordination issues
Chloral Hydrate
Sedative-hypnotic / CNS depressantMain Use
Short-term treatment (max 2 weeks) for severe insomnia specifically in neurodevelopmental disorders
Common Side Effects
Drowsiness (can last 24h), stomach irritation, nausea, paradoxical excitement. Very strict monitoring required.
What to Track
If your child is starting a second-line medication, it is vital to keep detailed logs to help your specialist assess the benefit vs potential side effects:
- Onset: How quickly do they fall asleep?
- Maintenance: How many times do they wake? How long for?
- Daytime Effects: Do they seem drowsy, irritable, or "hungover" the next day?
- Vital Signs: Some medications (like Clonidine) may require periodic blood pressure checks.
Professional Resources
⚠️ Critical Medical Disclaimer
Always consult with your GP or specialist paediatrician before starting, stopping, or changing any medication. Every child's medical history is unique, and these medications interact with other conditions and treatments in complex ways.