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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

  • 1School of Medicine, Indiana University, Indianapolis, USA.

Behavioral Sleep Medicine
|February 20, 2025
PubMed

Insights

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.

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.
Abstract

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