Clinical management of behavioral insomnia of childhood

Jennifer Vriend1, Penny Corkum

  • 1Clinical Psychology PhD Program, Dalhousie University, Halifax, Nova Scotia, Canada.

Insights

Behavioral insomnia affects 25% of children, causing sleep problems and negative effects. This paper reviews evidence-based behavioral interventions for childhood insomnia and discusses access barriers.

Area of Science:

  • Pediatric Sleep Medicine
  • Child Psychology
  • Behavioral Health

Background:

  • Behavioral insomnia is common in children, affecting about 25%.
  • It leads to sleep difficulties and adverse outcomes for children and families.
  • Developmental changes influence sleep and intervention effectiveness.

Purpose of the Study:

  • To review empirically supported behavioral interventions for childhood insomnia.
  • To explore developmental factors influencing behavioral insomnia.
  • To identify barriers to accessing these interventions.

Main Methods:

  • Literature review of empirically supported behavioral interventions.
  • Analysis of developmental influences on sleep and treatment.
  • Discussion of barriers to intervention access.

Main Results:

  • A range of behavioral interventions are effective for infant, child, and adolescent insomnia.
  • Biological, cognitive, and psychosocial factors impact sleep and treatment.
  • Healthcare providers often overlook effective behavioral interventions, hindering family access.

Conclusions:

  • Evidence-based behavioral interventions exist for childhood insomnia.
  • Understanding developmental changes is key to effective treatment.
  • Addressing access barriers is crucial for improving pediatric sleep health.

Related Concept Videos

Management of Insomnia01:19

Management of Insomnia

The sleep cycle, an integral part of human health, consists of several stages with distinct characteristics and functions. It begins with a transition from wakefulness to sleep, known as the light sleep phase, followed by the restorative deep sleep phase, essential for physical recovery and growth. The cycle concludes with the Rapid Eye Movement (REM) phase, characterized by high brain activity and vivid dreaming. Insomnia, a prevalent sleep disorder, involves difficulty falling asleep, staying...
Insomnia01:27

Insomnia

Insomnia is a prevalent sleep disorder characterized by difficulty falling asleep, frequent awakenings during the night, and waking up too early without being able to return to sleep. People with insomnia often experience these disruptions at least three nights a week for at least one month. Chronic insomnia, which lasts for at least three months, can lead to increased anxiety, which in turn can worsen sleep difficulties, creating a cycle of sleeplessness and stress.
Multiple factors contribute...
Nightmares and Night Terrors01:18

Nightmares and Night Terrors

Nightmares and night terrors represent two distinct types of sleep disturbances that differ in timing, characteristics, and the sleeper's recall of the event. Nightmares are vivid, disturbing dreams that usually awaken the sleeper from REM sleep, a stage of sleep where brain activity is high, and dreams are most frequent. Upon awakening, individuals often have detailed recollections of their nightmares, which can include themes of threats to survival, security, or self-esteem.
Nightmares often...
REM Sleep Behavior Disorder01:15

REM Sleep Behavior Disorder

REM Sleep Behavior Disorder (RBD) is a sleep disorder characterized by the absence of muscle paralysis that normally occurs during the REM phase of sleep. This absence allows individuals to physically act out their dreams, which are often vivid and disturbing. Common behaviors exhibited during episodes include kicking, punching, and yelling. These actions can be dangerous, potentially leading to injuries for the person with RBD or their bed partner.
RBD is significantly associated with...
CNS Depressants: Barbiturates and Benzodiazepines01:14

CNS Depressants: Barbiturates and Benzodiazepines

CNS depressants include drugs from the category of barbiturates and benzodiazepines. They are valuable medications for managing anxiety disorders and insomnia. Barbiturates, once used to induce and maintain sleep, have been replaced mainly by benzodiazepines due to barbiturate's toxicity, tolerance, and overdose risks. They interact with GABAA receptors, leading to sedation at low doses and potentially coma and death at higher doses. Phenobarbital, a long-acting barbiturate, possesses...
Operant Conditioning Intervention01:24

Operant Conditioning Intervention

Operant conditioning serves as a foundational principle in therapeutic interventions aimed at modifying maladaptive behaviors. Central to this approach is the notion that behaviors, both adaptive and maladaptive, are learned through reinforcement. By analyzing the environmental factors that reinforce problematic behaviors, clinicians can design interventions to weaken these reinforcements and replace maladaptive behaviors with healthier alternatives.
In operant conditioning, behaviors that are...