Behavioral Sleep Problems in Children and Adolescents

Abstract

Sleep problems in children and adolescents are common, and they impact multiple domains of child and family functioning. Psychologists have a critical role in the assessment and treatment of sleep problems and are integral to interdisciplinary sleep teams. Certain sleep problems may be related to co-morbid psychological or developmental conditions, and others are considered to be primarily medical, yet behavioral approaches may be applicable. There are also sleep problems considered to be behavioral in etiology (e.g. inadequate sleep hygiene, behavioral insomnia of childhood, nightmares/bad dreams/nighttime fears, delayed sleep phase syndrome, and psychophysiological insomnia). In this article, the assessment of behavioral sleep problems, as well as specific behavioral sleep disorders, and their treatments will be discussed.

Sleep Habits and Factors Associated with Sleep Problems Among Children in Southeastern Turkey

“…The child likely will also have difficulty returning to sleep independently during normative night waking. 6 Consistent with the literature, difficulty falling asleep was determined to be more common among children soothed by parents when awaking at night, in our study. These findings suggest that parental behaviours may play an important role in the development of sleep problems in children.…”

“…1,5 Sleep problems may persist if not adequately managed and may lead to health issues in children such as obesity, insulin resistance, cardiovascular/immune system disorders, anxiety, and depression. 1,6,7 The most common way of obtaining information about the sleep habits of children is through observation of the families. [8][9][10] Identifying sleep characteristics such as the duration of sleep and bedtime/daytime sleep habits is very important in understanding sleep-related problems.…”

Sleep in Childhood and Adolescence: Age-Specific Sleep Characteristics, Common Sleep Disturbances and Associated Difficulties

“…While arousals from sleep are a usual part of sleep architecture (Sadeh 1994), parents of children experiencing SOA consider their child night--wakings to occur much more frequently, and attempts by the child to return to sleep independently are often unsuccessful without the aid of a comforting stimulus (Moore 2012). Often the presence of a parent is necessary for the child to return to sleep in cases where parents form a part of the sleep association (such as holding a bottle or feeding), and thus parental presence in the bedroom often predicts the likelihood of night--wakings in children (Sadeh et al 2009).…”

“…give in to the child and allow them to determine their own sleep time and bedtime routine (Moore 2012). Once limits are set, however, problems are typically eliminated.…”

“…Once limits are set, however, problems are typically eliminated. The combined type, involving both inappropriate sleep associations and difficulties with limit setting, often manifests as a refusal to go to bed accompanied by crying or tantrums, which results in the parent comforting the child in the bedroom -- thus reinforcing the behaviour and creating negative sleep associations consistent with SOA (Moore 2012). Behavioural interventions, such as improved sleep hygiene, including a bedtime routine, and extinction (preventing reinforcement of inappropriate behaviour, allowing the child to break negative sleep associations) are effective treatments for BIC (Mindell et al 2006).…”