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Behavioral interventions for pediatric insomnia: one treatment may not fit all

Michal Kahn1, Michal Juda-Hanael1, Efrat Livne-Karp1

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

Sleep
|November 3, 2019
PubMed

Insights

For infant sleep problems, the Camping-out intervention is more effective for highly anxious infants than Graduated extinction. This personalized approach to pediatric insomnia treatment improves sleep for most families.

Area of Science:

  • Pediatric Sleep Medicine
  • Developmental Psychology
  • Behavioral Therapy

Background:

  • Behavioral interventions for pediatric insomnia are effective but lack personalization for specific patient groups.
  • Infant separation anxiety's role in moderating treatment outcomes is not well-established.

Purpose of the Study:

  • To evaluate the moderating effect of infant separation anxiety on two brief behavioral interventions for infant sleep problems.
  • To compare the efficacy of Graduated extinction (Checking-in) versus Camping-out interventions.

Main Methods:

  • A randomized controlled trial involving 91 infants (9-18 months) with pediatric insomnia.
  • Interventions included Checking-in (gradual extinction) and Camping-out (parental presence).
  • Sleep was assessed via actigraphy and parent reports; separation anxiety was measured in a laboratory setting.

Main Results:

  • Both interventions improved infant sleep, with benefits sustained at 6-month follow-up.
  • Infant separation anxiety moderated treatment efficacy.
  • The Camping-out intervention showed greater benefits for infants with high separation anxiety compared to Checking-in.

Conclusions:

  • Infant separation anxiety should be considered when personalizing pediatric insomnia treatments.
  • Pediatricians may consider assessing separation anxiety to guide treatment choices.
  • Gentler approaches like Camping-out may be preferable for highly anxious infants over Graduated extinction.
Abstract

Keywords:
actigraphyinfant sleeppediatric insomniarandomized controlled trialseparation anxiety

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