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Behavioral treatment of bedtime problems and night wakings in infants and young children

Jodi A Mindell1, Brett Kuhn, Daniel S Lewin

  • 1Department of Psychology, Saint Joseph's University, 5600 City Avenue, Philadelphia, PA 19131, USA. jmindell@sju.edu

Sleep
|October 31, 2006
PubMed

Insights

Behavioral treatments effectively address childhood sleep issues like bedtime problems and night wakings. These therapies show reliable, lasting improvements in over 80% of children, offering a strong evidence-based approach.

Area of Science:

  • Pediatric Sleep Medicine
  • Behavioral Therapy

Background:

  • Bedtime problems and night wakings are common in young children.
  • Effective clinical management strategies are needed.

Purpose of the Study:

  • To review evidence on behavioral treatments for childhood sleep issues.
  • To inform practice parameters for the American Academy of Sleep Medicine.

Main Methods:

  • Systematic review of 52 treatment studies.
  • Analysis based on Sackett criteria for evidence-based treatment.

Main Results:

  • Behavioral therapies demonstrate reliable and durable efficacy.
  • 94% of studies reported efficacious behavioral interventions.
  • Over 80% of children showed clinically significant, maintained improvement (3-6 months).
  • Strong support for unmodified extinction and parent education.
  • Support for graduated extinction, bedtime fading/positive routines, and scheduled awakenings.

Conclusions:

  • Behavioral treatments are highly effective for childhood sleep problems.
  • Further research needed on delivery methods, long-term efficacy, and pharmacologic agents.
  • Standardized criteria and objective measures are encouraged for pediatric sleep research.

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