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Treatment of infant sleep disturbance by trimeprazine in combination with extinction
K G France1, N M Blampied, P Wilkinson
1Department of Psychology, University of Canterbury, Christchurch, New Zealand.
Insights
Combining behavioral extinction with a reducing dose of sedative medication effectively and rapidly resolved chronic sleep disturbances in preschool children. This approach improved infant security and reduced maternal anxiety, with lasting benefits observed at follow-up.
Area of Science:
- Pediatric Sleep Medicine
- Behavioral Psychology
- Pharmacology
Background:
- Chronic sleep disturbances are prevalent in preschool-aged children, often managed with short-term sedatives.
- Behavioral extinction, while effective, can cause temporary distress due to post-extinction activity.
- Existing treatments offer limited long-term solutions for pediatric sleep issues.
Purpose of the Study:
- To evaluate the efficacy of combining behavioral extinction with a tapering dose of sedative medication (trimeprazine tartrate) for chronic sleep disturbances in preschoolers.
- To compare this combined approach against extinction alone and a placebo control group.
Main Methods:
- A double-blind, placebo-controlled study design was employed.
- Participants were divided into three groups: extinction with tapering sedative, extinction alone, and placebo.
- Trimeprazine tartrate was administered in a reducing dosage over the initial 10 days of the extinction protocol.
Main Results:
- All groups showed a reduction in sleep disturbance, with the medication group exhibiting an abrupt decline.
- The extinction and placebo groups demonstrated a slower rate of improvement in sleep disturbance.
- Sustained improvements in sleep were maintained at follow-up, alongside enhanced infant security and decreased maternal anxiety.
Conclusions:
- Combining behavioral extinction with a tapering dose of trimeprazine tartrate offers an effective and rapid solution for pediatric sleep disturbances.
- This integrated approach not only resolves sleep issues but also positively impacts child security and maternal well-being.
- The findings support a novel therapeutic strategy for managing chronic sleep problems in young children.
Abstract:
Chronic sleep disturbance is a common problem in preschool children. Prescription and non-prescription sedatives provide short-term palliative relief. Behavioral extinction by withdrawal of parental attention is enduringly effective but may be distressing short-term because of postextinction bursts of intense activity by the child. This study evaluated the effects of combining extinction and sedative medication (trimeprazine tartrate), prescribed in a reducing dose over the first 10 days of extinction. Control groups received either extinction alone or a placebo administered double-blind. After baseline, all subjects reduced their sleep disturbance to low levels, the extinction and placebo groups declining slowly, the medication group abruptly. These gains were maintained at follow-up. Measures of infant security and maternal anxiety showed improvements with treatment.