Behavioural and cognitive-behavioural interventions for sleep disorders in infants and children: A review (original) (raw)
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Sleep Medicine Reviews, 1999
This review covers the literature on behavioural and cognitive-behavioural treatments for sleep disturbance in infants, preschool , and school-age children. Treatment areas are dyssomnias (disorders of initiating, maintaining, or excessive sleep) and parasomnias (behaviours which occur predominantly during sleep). Interventions aimed at preventing sleep disorder through targeting infant sleep patterns are also examined. Controlled experimental studies are the main focus of this review but case studies and clinical reports are also included. It is concluded that, for families willing to undertake behavioural and cognitivebehavioural interventions, some treatments appear effective for some infant and child sleep problems, in the short term at least. The adequacy of current research is discussed, and suggestions for future research are given.
A systematic review of prevention and treatment of infant behavioural sleep problems
Acta Paediatrica
The evolution of sleep-wake patterns from multiple sleep episodes to one main consolidated sleep episode at night is a complex developmental process substantially engaging and challenging the parents during the first years. Sleep behaviour problems are developmentally normative; yet, parents who are able to attain appropriate strategies for settling their babies may decrease their child´s risk for longlasting problems. It is important to establish good sleep routines and gradually teach their baby to self-soothe. If parents do not have effective strategies for settling their baby, it can lead to ongoing adjustment problems for the baby. 1 Complaints about difficulty falling
Behavioral Interventions for Infant Sleep Problems: A Randomized Controlled Trial
Pediatrics, 2016
To evaluate the effects of behavioral interventions on the sleep/wakefulness of infants, parent and infant stress, and later child emotional/behavioral problems, and parent-child attachment. A total of 43 infants (6-16 months, 63% girls) were randomized to receive either graduated extinction (n = 14), bedtime fading (n = 15), or sleep education control (n = 14). Sleep measures included parent-reported sleep diaries and infant actigraphy. Infant stress was measured via morning and afternoon salivary cortisol sampling, and mothers' self-reported mood and stress. Twelve months after intervention, mothers completed assessments of children's emotional and behavioral problems, and mother-child dyads underwent the strange situation procedure to evaluate parent-child attachment. Significant interactions were found for sleep latency (P < .05), number of awakenings (P < .0001), and wake after sleep onset (P = .01), with large decreases in sleep latency for graduated extinction a...
Sleep
Bedtime problems and frequent night wakings are highly prevalent in infants, toddlers, and preschoolers. Evidence suggests that sleep disruption and/or insufficient sleep have potential deleterious effects on children's cognitive development, regulation of affect, attention, health outcomes, and overall quality of life, as well as secondary effects on parental and family functioning. Furthermore, longitudinal studies have demonstrated that sleep problems first presenting in infancy may become chronic, persisting into the preschool and school-aged years. A solid body of literature now exists supporting the use of empirically-based behavioral management strategies to treat bedtime problems and night wakings in infants, toddlers, and preschoolers. The following practice parameters present recommendations for the use of behavioral (i.e., non-pharmacological) treatments of bedtime problems and night wakings in young children (aged 0 - 4. years 11 months). A companion review paper on ...
Cognitive–behavioral treatment for childhood sleep disorders
Clinical Psychology Review, 2005
Sleep problems are very prevalent during childhood and may have adverse developmental impact. The efficacy of a number of cognitive-behavioral interventions for the most prevalent problems such as difficulty falling asleep and night-wakings has been repeatedly demonstrated with relatively rapid outcomes and high success rates. Preventive interventions in infancy have shown some promise in lowering the rates of sleep problems in infants of trained parents. Cognitive-behavioral interventions have also been proposed for childhood parasomnias (sleepwalking, night terrors, nightmares, and rhythmic behaviors), however, very limited research has been conducted to assess the efficacy of these interventions. Specific methodological issues, limitations and needs have been identified in the clinical literatures. These issues include: (a) integrating objective sleep assessment methods in clinical research; (b) identifying the specific curative factors of various effective interventions; (c) the absence of long-term follow-up studies for assessing relapse problems; (d) assessing the role of mode of delivery (i.e., professional consultation versus written information) in treatment efficacy; and (e) the need to expand the research on clinical interventions for the parasomnias.
Sleep problems in pre-school children: a review of the literature
Child: Care, Health and Development, 1994
This paper reviews the literature on sleep problems in preschool children, aiming to raise awareness of the current knowledge in this . field. The article begins with a discussion of the prevalence of sleep problems in young children. Disorders of initiating and maintaining sleep are by far the most common type of sleep problem in this age group, and are therefore the focus of this review. The effects of sleep disturbance are examined, focusing on how parents often feel desperate and in need of support outside the family. The causes of sleep problems are considered and the complexity in identifying causal factors is highlighted. The article continues with an exploration of the treatment of sleep problems, suggesting that much of the advice given to parents is contradictory. The literature demonstrates that the use of medication is common, but it appears that this method of treatment is of limited benefit. It seems that behaviour modification or a psychodynamic approach may be much more successful, and the use of self-help manuals/booklets has been shown to be useful by some authors. Finally, preventative strategies are discussed highlighting the need for further research in this area.
Sleep, 2006
Bedtime problems and frequent night wakings are highly prevalent in infants, toddlers, and preschoolers. Evidence suggests that sleep disruption and/or insufficient sleep have potential deleterious effects on children's cognitive development, regulation of affect, attention, health outcomes, and overall quality of life, as well as secondary effects on parental and family functioning. Furthermore, longitudinal studies have demonstrated that sleep problems first presenting in infancy may become chronic, persisting into the preschool and school-aged years. A solid body of literature now exists supporting the use of empirically-based behavioral management strategies to treat bedtime problems and night wakings in infants, toddlers, and preschoolers. The following practice parameters present recommendations for the use of behavioral (i.e., non-pharmacological) treatments of bedtime problems and night wakings in young children (aged 0 - 4. years 11 months). A companion review paper on ...
Chapter - Behavioural Management of Paediatric Sleep Difficulties
Allergy and Sleep, 2019
This chapter is a brief overview of a range of behavioural approaches that can be used to help support people who are experiencing sleep difficulties. The core aspects of these management strategies are the same regardless of the specific health difficulties people might be experiencing. Management of atopy-related symptoms should be optimised in order for behavioural techniques to have the best possible chances of success. There may be situations in which the management of atopy might itself impact on sleep, or become associated with getting to sleep, in which case these should be considered carefully in order to give the patient the best chance of independently managing their symptoms, so that in the event of sleep difficulties they are not reliant on other people for their resolution. Essential foundations of good sleep include a consistent sleep schedule with a regular bedtime routine, which does not change on non-work or school days, and an age-appropriate bedtime.
Managing sleep disorders in children: which is the best strategy?
Georgian medical news
This review aims to critically analyze the literature studies showing the effectiveness of cognitive-behavioral strategies in the treatment of sleep disorder during the developmental age. About 15-35% of children suffer from sleep disorder. If they are not treated right away, it can persist into adulthood. Recent studies demonstrate an effective cognitive-behavior treatment for these disturbances. In this regard, the most effective method seems to be extinction (standard, with parental presence, graduated), the bedtime routine, scheduled awakenings, and preventive parent education. The procedures of extinction, not only its effectiveness, have limited application for the difficulty that compares to the parents following the procedure of the intervention. They are not able to ignore their children when they are crying for long prolonged period of time. Bedtime routine is relevant in the prevention and treatment of sleep disorders. The scheduled awakenings are a useful technique that ...