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 The study focused on 90 children, ages 4 to 6, with severe and
persistent fears that interfere with normal functioning and cause
considerable stress for kids and their families.
These night terrors affect about 10 percent of children, and are
much more debilitating than the occasional nightmares that wake kids
every so often.
Researchers randomly assigned the children into two groups. One
group received cognitive behavior therapy involving structured play
with their parents designed to build coping skills. The other group
received non-directive therapy involving playtime with parents but
no guidance on how to manage the sleep issues.
Four weeks after treatment, all of the children had significantly
fewer nighttime fears and sleep disruptions. With cognitive therapy,
however, parents reported more improvements in sleep and behavior.
This suggests that cognitive behavior therapy, an established
treatment for older kids with sleep problems, may also work with
young children when a play component is added, said lead study
author Michael Kahn of Tel Aviv University in Israel.
"The take-home message for parents is that sleep problems in the
preschool age can be successfully treated with very brief
interventions," Kahn said by email.
"Parents could try addressing the problem on their own by being
aware of their own cognitions and knowledge regarding sleep (for
example, understanding the importance of regular bedtime routines),
by speaking to their child about it and trying to find creative
solutions that would help him or her to spend the night in their own
bed (e.g., using a stuffed animal, a flashlight, placing a picture
of the family near the child’s bed, etc.), and by limiting the
extent of their accommodation to the child’s attempts to avoid
falling and staying asleep in his own bed," Kahn added.
For kids receiving cognitive behavior therapy in the study,
researchers encouraged parents and kids to role play with dolls in a
doll house bedroom to practice bedtime routines. Children would act
out going to sleep and parents would gradually play smaller and
smaller parts at bedtime and during the night to model the
independent sleep habits they wanted kids to develop.
During these games, kids could earn rewards like stickers after
successfully completing sleep exercises.
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Children assigned to the control group didn't get guidance on how to
practice a good bedtime routine or cope with nighttime awakenings
during the playtime with parents.
Researchers measured sleep using devices that track sleep, called
actigraphs, and by asking parents how well children slept.
The actigraph measurements didn't show more sleep improvement with
cognitive behavior therapy, but parents in this group reported
greater reductions in kids’ sleep problems and co-sleeping,
researchers report in Sleep Medicine.
The researchers admit that because they used a variety of different
therapy approaches, it’s difficult to pinpoint how each treatment
component may have influenced how well kids managed to sleep through
the night in their own beds.
The study may also have been too small to determine statistically
meaningful differences in some of the interventions tested.
Even so, the findings add to a large body of evidence suggesting
behavior therapy helps reduce bedtime problems and nighttime
awakenings, said Jocelyn Thomas, a psychology researcher at the
Children’s Hospital of Philadelphia who wasn't involved in the
study.
"This treatment is based on the theory of learned behavior and
involves teaching the parent to manage the child's behavior," Thomas
said by email.
SOURCE: http://bit.ly/2ioptjM Sleep Medicine, online December 23,
2016.
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