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A systematic review of treatments for settling problems and night waking in young children
P Ramchandani1, L Wiggs, V Webb
1University of Oxford Section of Child and Adolescent Psychiatry, Park Hospital for Children, Headington, Oxford OX3 7LQ. paulgulab@aol.com
Insights
Behavioral interventions are more effective for childhood sleep problems than drugs. This systematic review found behavioral strategies offer both short-term and potential long-term benefits for settling issues and night waking in young children.
Area of Science:
- Pediatrics
- Sleep Medicine
- Behavioral Science
Background:
- Settling problems and night waking are common in young children.
- These sleep disturbances can significantly impact children and their families.
Purpose of the Study:
- To evaluate the effectiveness of different treatments for settling problems and night waking in children aged five years or younger.
- To compare drug-based and non-drug-based interventions.
Main Methods:
- Systematic review of randomized controlled trials.
- Inclusion criteria: children aged ≤5 years with sleep problems, interventions with comparisons (placebo, waiting list, or alternative treatment).
- Outcomes measured: night waking frequency, time to settle, and duration of sleep problems.
Main Results:
- Pharmacological treatments showed short-term efficacy for night waking, but long-term benefits were uncertain.
- Behavioral interventions demonstrated both short-term effectiveness and potential for sustained improvement in settling and night waking.
Conclusions:
- Behavioral interventions are recommended for childhood sleep problems due to their lasting benefits.
- Given the prevalence and impact of these issues, long-term solutions like behavioral strategies are highly desirable.
Objectives:
To assess the efficacy of treatments for settling problems and night waking in young children.
Design:
A systematic review of randomised controlled trials of interventions for settling problems and night waking in young children.
Setting:
Electronic bibliographic databases and references on identified papers, hand searches, and personal contact with specialists.
Subjects:
Children aged 5 years or less who had established settling problems or night waking.
Interventions:
Interventions had to be described and a placebo, waiting list, or another intervention needed to have been used as a comparison. Interventions comprised drug trials or non-drug trials.
Main Outcome Measures:
Number of wakes at night, time to settle, or number of nights in which these problems occurred.
Results:
Drugs seemed to be effective in treating night waking in the short term, but long term efficacy was questionable. In contrast, specific behavioural interventions showed both short term efficacy and possible longer term effects for dealing with settling problems and night waking.
Conclusions:
Given the prevalence and persistence of childhood sleep problems and the effects they can have on children and families, treatments that offer long lasting benefits are appealing and these are likely to be behavioural interventions.