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The Sleep Train Program: Efficacy of a Behavioral Sleep Intervention for Children with Externalizing Problems.

Sarah M Honaker1, Caroline Hoyniak2, Maureen E McQuillan1

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A brief behavioral sleep intervention improved sleep and behavior in children with both externalizing and sleep difficulties. The Sleep Train Program was not effective for children with only externalizing problems.

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Area of Science:

  • Pediatric behavioral health
  • Sleep science
  • Child psychology

Background:

  • Externalizing behavior problems in children are common and can be exacerbated by sleep difficulties.
  • Behavioral sleep interventions show promise for improving child outcomes.
  • The Sleep Train Program is a brief intervention designed to address sleep issues.

Purpose of the Study:

  • To evaluate the efficacy of the Sleep Train Program, a brief behavioral sleep intervention, for children aged 3-8 years with externalizing behavior problems.
  • To compare the intervention's impact on sleep and behavior in children with and without comorbid sleep difficulties.

Main Methods:

  • Randomized controlled trial with a crossover design, comparing a behavioral sleep intervention to an active control (mealtime intervention).
  • Participants included children presenting to a behavioral health clinic for externalizing problems.
  • Outcomes assessed via parent-report and actigraphy for sleep and behavior.

Main Results:

  • In children with comorbid sleep and externalizing difficulties, the behavioral sleep intervention significantly reduced externalizing problems, night wakings, and improved parent-child bedtime interactions and child behavior.
  • The intervention did not yield significant improvements in the full sample (including children without sleep difficulties).
  • Across groups, the intervention led to fewer externalizing behaviors, improved sleep habits, and better parent-child bedtime interactions.

Conclusions:

  • The Sleep Train Program is effective for children experiencing both externalizing behavior problems and sleep difficulties.
  • The intervention's efficacy is specific to children with comorbid sleep issues, not those with only externalizing problems.