Geographic variations in treatment of sleeping disorders in children focusing on melatonin and weighted blankets in Sweden

Sammanfattning: Introduction: Sleeping disorders are common in the paediatric population. Geographic data over prescription of melatonin exist in Sweden but no collected data exists over prescription of weighted blankets (WB). It has been hypothesised that WB can lower the usage of sleeping medication, but possible correlations to melatonin have not been defined. Aim: Investigate geographic variations in treatment for sleeping disorders in children, specifically prescribed melatonin and WB, and possible correlations between their prescription rates. Method: Nationwide study with a retrospective observational design including all regions in Sweden regarding 2015-2021. Children and adolescents between 0-17 (or 0-19) years old with prescription of melatonin or WB were included. Data of prescription of melatonin was retrieved from The National Prescribed Drug Register. Data concerning WB was obtained via contacts with personnel from each region. Results: Prescription of melatonin increased by 3-fold between 2015-2021 in children 0-17 years. Melatonin was more frequently prescribed to lower age-categories compared to WB. Findings demonstrated considerable variations in prescription of WB geographically and over time, with rising prescriptions in 2015-2019, thereafter declining after released national recommendations. No clear correlation between the prescription rates for the two treatments in the regions was found. Conclusions: This is the first nationwide study that has investigated prescription of WB to children in Sweden. There were geographic variations in prescription of both melatonin and WB and findings show no consensus regarding treatment of sleeping disorders in children. There are currently changes regarding treatment of sleeping disorders and further evaluations and studies are needed.