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Cognitive-behavioral versus non-directive therapy for preschoolers with severe nighttime fears and sleep-related

Michal Kahn1, Alon Ronen1, Alan Apter2

  • 1School of Psychological Sciences, Tel Aviv University, Tel Aviv, Israel.

Sleep Medicine
|April 4, 2017
PubMed

Insights

Cognitive-behavioral therapy including parent involved play (CBT-PIP) effectively reduced nighttime fears and sleep problems in preschoolers. While not superior to the control in all measures, CBT-PIP improved behavioral aspects of nighttime fears and increased parent satisfaction.

Area of Science:

  • Pediatric Psychology
  • Sleep Medicine
  • Child Psychiatry

Background:

  • Severe nighttime fears and sleep disturbances are common in preschoolers.
  • Cognitive-behavioral therapy (CBT) is a recognized treatment for childhood anxiety and sleep issues.
  • Parental involvement can enhance therapeutic outcomes in young children.

Purpose of the Study:

  • To evaluate the efficacy of a specific CBT protocol for preschoolers with severe nighttime fears and sleep problems.
  • To compare this CBT protocol, cognitive-behavioral therapy including parent involved play (CBT-PIP), against an active control treatment.
  • To assess improvements in sleep, nighttime fears, and parent satisfaction.

Main Methods:

  • A randomized controlled trial involving 90 preschoolers (aged 4-6 years) and their parents.
  • Participants were assigned to either CBT-PIP or triadic expressive play therapy (TEPT) as an active control.
  • Assessments included actigraphy, sleep logs, diagnostic interviews, and parent questionnaires at baseline, during treatment, and post-treatment.

Main Results:

  • Both CBT-PIP and TEPT groups showed significant reductions in nighttime fears and sleep disruptions.
  • Parent reports favored CBT-PIP, showing greater decreases in sleep problems, co-sleeping, and higher satisfaction.
  • Objective sleep measures did not differ significantly between the two groups post-treatment.

Conclusions:

  • CBT-PIP demonstrated significant benefits in reducing the behavioral manifestations of nighttime fears in preschoolers.
  • While not outperforming the active control in all sleep parameters, CBT-PIP offered advantages in parent-reported outcomes and satisfaction.
  • The findings support CBT-PIP as a valuable intervention for addressing complex sleep-related issues in young children.
Abstract

Keywords:
Cognitive–behavioral therapyNighttime fearsPreschoolSleep-related problems

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