ObjectiveDespite the success of behavioural sleep support interventions in the third sector, sleep support is not universally available for families in the UK. The aim of the study was to provide evidence of efficacy and to propose a delivery model for integrated sleep support for families of vulnerable children.Design and settingA sleep support intervention was carried out in Sheffield Local Authority evaluated using a preintervention and postintervention study design by Sheffield Children’s National Health Service (NHS) Trust.ParticipantsFifty-six children aged 6–16 years with significant sleep problems were recruited; 39 completed the intervention and evaluation.InterventionsBasic sleep education and an individualised programme was delivered by a sleep practitioner. Follow-on telephone support was provided to empower the parent (and/or young person) to carry out the sleep programme at home. An integrated NHS and Local Authority delivery model was designed and implemented.ResultsParents’ ratings of their child’s ability to self-settle improved from 1.1/10 to 6.4/10 (p<0.05). Mean Warwick-Edinburgh Mental Well-being Scale scores improved significantly for parents/carers (MD 5.16, 95%CIs 2.62 to 7.69, p<0.05). Children who completed the intervention gained on average an extra 2.4 hours sleep a night. There was reduction in healthcare utilisation, illnesses and medication use.ConclusionsThe behavioural approach to sleep support for these vulnerable groups of children is highly effective. Follow-on individual support to empower parents is key to achieving success. Sleep support can be implemented in NHS and Local Authority services by integration into the existing workforce using a cross-agency model.

Aim A partnership involving a Children's Trust, the City Council and a Sleep Charity evaluated a behavioural intervention to provide support to parent/carers and young people to improve sleep patterns. Methods The intervention entailed basic education about sleep, a one-to-one session with a sleep practitioner to create an individual sleep programme and telephone support to empower the parent to carry out the sleep programme at home. Results 39 children completed the intervention and evaluation, median age 8.56 years (range 1.82-15.75 years). 79.5% were male. 75% had a diagnosis of ADHD or were awaiting assessment, the remaining 25% were Looked After or Adopted Children (of whom 10% also had ADHD). Parents' ratings of their child's ability to self-settle to sleep improved from 1.13/10 to 6.73/10 after the intervention (MD 5.62, 95% confidence intervals 4.56-6.69, p<0.05). Children gained on average an extra 2.4 hours sleep a night. The average number of hours of sleep that the child actually got was 6.27 hours at baseline and 8.62 after the intervention (MD 2.35, 95% CI 1.64-3.06, p<0.05). There was a statistically significant improvement in time taken to settle, time to fall asleep, number and duration of night-time wakenings.The primary word used to describe the mood of the child on wakening before the intervention was 'grumpy' and after the intervention was 'happy'. The impact of sleep deprivation on the parents' wellbeing improved for all measures. The overall WEMWBS score improved significantly following the intervention (MD 8.84, 95% CI 5.32-12.36, p<0.05). There was a reduction in the number of illnesses in both parent/ carers and children following the intervention. Although some parents did not find the programme helpful, 100% said they would recommend it to others. Conclusion The evaluation gave us confidence in the delivery model. 'Regular telephone calls and support' and 'Learning about sleep' were the main positive factors. Our partnership working brought together the individual strengths, drive and passion that were critical for delivery, planning, and influencing better provision for families.We have established a strategic group to support local implementation and produced a draft delivery model which we believe is replicable for other areas.

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