News Release

Behavioural treatment may help solve childhood sleep problems

Peer-Reviewed Publication

BMJ

A systematic review of treatments for settling problems and night waking in young children

Difficulties in settling down to sleep and waking during the night are the most common sleep problems in young children, affecting about 20 per cent of children aged one to three years. In this week's BMJ a team of researchers from Oxford report that the most effective long term treatments for such problems are behavioural interventions, using a variety of psychological techniques, which teach children appropriate sleeping habits.

Dr Paul Ramchandani and colleagues from the University of Oxford Department of Psychiatry at the Park Hospital for Children reviewed nine studies previously conducted into the efficacy of drug and non-drug treatments for children's sleep problems . They found that overall drug treatments (using sedatives) seemed to be effective in the short term but in the longer term their efficacy was "unimpressive". However, the authors also found that behavioural interventions were more likely to be both effective in the short term and to have continuing benefits in the longer term.

The behavioural interventions that were covered in their review included:- "positive routines" which involve creating a 20 minute winding down bedtime routine, which is gradually brought forward by 5-10 minutes per week to an appropriate bedtime; varying degrees of "extinction", where a child is left to cry and "scheduled wakes" where parents wake their child before they usually wake spontaneously and then resettle them to sleep in their usual manner.

Ramchandani et al conclude that given the prevalence and persistence of childhood sleep problems and the effects they can have on children and families, treatments that have long lasting benefits are more appealing and these are likely to be behavioural interventions.

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Contact:

Dr Paul Ramchandani, Specialist Registrar, Child and Family Psychiatry Service, Sue Nicholls Centre Aylesbury

Email: paulgulab@aol.com


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