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Cognitive and Behavioral Interventions to Improve Sleep in School-Age Children and Adolescents: A Systematic Review

Lie Åslund1,2, Filip Arnberg1,3, Marie Kanstrup1,4

  • 1Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.

Journal of Clinical Sleep Medicine : JCSM : Official Publication of the American Academy of Sleep Medicine
|October 31, 2018
PubMed

Insights

Cognitive behavioral sleep interventions effectively reduce sleep onset latency in children and adolescents. While total sleep time showed no self-reported improvement, actigraphy indicated a slight increase, with benefits sustained at follow-up.

Area of Science:

  • Pediatrics
  • Sleep Medicine
  • Behavioral Science

Background:

  • Sleep problems are prevalent in children and adolescents, often exacerbating existing comorbid conditions.
  • Effective interventions are crucial for improving pediatric sleep quality and overall health.

Purpose of the Study:

  • To evaluate the efficacy of cognitive and behavioral sleep interventions in school-age children and adolescents.
  • To analyze effects on total sleep time, sleep onset latency, wake after sleep onset, and daytime sleepiness.

Main Methods:

  • Systematic literature search identifying six randomized controlled trials (n=528).
  • Data extracted on sleep onset latency, total sleep time, wake after sleep onset, and daytime sleepiness using ratings and actigraphy.
  • Analysis included immediate post-intervention and short-term follow-up data.

Main Results:

  • Sleep onset latency significantly decreased with interventions, measured by both sleep diaries and actigraphy.
  • Actigraphy showed a small but significant increase in total sleep time.
  • No significant effects were observed for wake after sleep onset or daytime sleepiness immediately post-intervention.
  • Follow-up data indicated sustained improvements in sleep onset latency and wake after sleep onset.

Conclusions:

  • Cognitive and behavioral sleep interventions show promise for improving sleep in pediatric populations.
  • Heterogeneity in treatment protocols and high risk of bias necessitate cautious interpretation of findings.
  • Further large-scale, rigorous trials are required to confirm efficacy and refine interventions.
Abstract

Keywords:
adolescencecognitive behavioral therapyinsomniainterventionmeta-analysisschool-age childrensleepsleep disordersystematic review

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