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External Validity of the Multicomponent Group Treatment KiSS for School-Aged Children With Insomnia

Barbara Schwerdtle1, Andrea Kübler1, Angelika Schlarb2

  • 1Institute of Psychology, University of Würzburg, Würzburg, Germany.

Behavioral Sleep Medicine
|November 29, 2018
PubMed

Insights

The KiSS program significantly improved pediatric insomnia, with most children no longer meeting diagnostic criteria one year post-treatment. This effective intervention for childhood insomnia showed stable results and high acceptance.

Area of Science:

  • Pediatric Sleep Medicine
  • Child Psychology
  • Behavioral Therapy

Background:

  • Insomnia is prevalent in school-aged children, frequently co-occurring with other mental health conditions.
  • The KiSS program, a multicomponent intervention, was evaluated in a pediatric insomnia clinic.
  • The study targeted an
  • all-comer
  • population, including children with comorbid disorders.

Purpose of the Study:

  • To assess the effectiveness and acceptance of the six-session KiSS treatment for pediatric insomnia.
  • To evaluate the long-term stability of treatment outcomes.
  • To determine the program's suitability for children with comorbid mental health issues.

Main Methods:

  • Forty-five families with children aged 5-10 years were randomized to either the KiSS intervention or a wait-list control group.
  • The KiSS program integrated cognitive behavioral therapy for insomnia (CBT-I), hypnotherapy, and imagination techniques.
  • Sleep diaries were used to track sleep efficiency (SE) and sleep-onset latency (SOL) before, immediately after, and 3, 6, and 12 months post-intervention.

Main Results:

  • The KiSS intervention led to significant sleep improvements, with only 1.75% of treated children meeting insomnia criteria at 12 months.
  • Sleep efficiency (SE) improved to 96%, and sleep-onset latency (SOL) decreased to 23 minutes, with normalized total sleep time.
  • All observed sleep improvements were sustained for at least one year, and the program demonstrated high acceptance with zero dropouts during treatment.

Conclusions:

  • The multimodal KiSS sleep training effectively improves sleep in children with insomnia, including those with comorbid mental disorders.
  • The program's structure, with three sessions for parents and three for children, allows for easy implementation as a standalone or adjunctive therapy.
  • Further research, including dismantling studies and trials with active control groups, is warranted.

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