Novel sleep management method in a toddler displaying fear and trauma: the Boss of My Sleep Book

© 2017 BMJ Publishing Group Ltd. Sleep problems in toddlers occur in ∼40% of children and increase the likelihood of postnatal depression. Most sleep training in toddlers requires contact with a trained professional, and requires a parent to ignore their child's cries, causing distress to many children and parents, increasing attrition and leaving families untreated and at risk. This case study reports success in significantly ameliorating sleep reluctance and bedtime fears in a sleep disturbed toddler with a history of trauma. It uses a novel use of bedtime behaviour management with some positive reinforcement techniques, called the Boss of My Sleep book: a non-cry, online (thus readily and cheaply available without a trained professional) sleep intervention. The system was successful immediately and was sustained after 6 months. The Boss of My Sleep book shows promise as a sleep intervention in toddlers, particularly for those parents who do not want to use cry intensive methods

Sleep therapy is effective in reducing symptoms of depression among adolescents

Owing to physiological and societal factors, adolescent sleep patterns undergo significant changes compared to preadolescent sleep. These changes often involve later bedtimes during the school week and the subsequent need for catch-up sleep and later wake-up times during the weekend. 1 Adolescents also have a high incidence of depression related to sleep loss, improving sleep patterns improves mood status

Better sleep for school-aged children

Although most young people experience sleep problems at one time or another these problems are largely transitory parts of normal development. However some sleep disturbance can develop into chronic problems that can significantly impair daytime functioning

Objective and subjective sleep measurement; parental perceptions and implications for clinical practice

Sleep knowledge and parental perceptions of infant sleep vary considerably among parents of infants. Parents can report their infant as having a severe sleep problem despite objective methods often differing from subjective measurements. This might suggest that parents are misinterpreting sleep as a problem when in fact it is a normal sleep pattern. This can have clinical implications and lead to a sleep intervention instead of a basic psychoeducation and further can impact significantly on the mental health of parents. This study aimed to assess whether parents can accurately identify a sleep problem in their child

Why we must care about the interrelationship between media, sleep and memory in children and adolescents : a commentary on Dworak and Walter

The paper presented by Dworak and Walter [1] raises some important and interesting points. Rightly they note that media usage has been steadily increasing over recent years, but more particularly that it has increased disproportionately in the last 5 years [2]. The paper delineates the impact of media usage on sleep, followed by the importance of sleep for memory consolidation in order to explore their relationships

Behavioural sleep disorders across the developmental age span : an overview of causes, consequences and treatment modalities

Behavioural sleep problems, that is, sleep problems that do not have a physiological aetiology, but rather a behavioural or psychological aetiology, are reported in between 20% - 40% of children and adolescents. These sleep disorders are categorised as Behavioural Insomnia of Childhood (BIC) in the International Classification of Sleep Disorders. BIC can result in short sleep duration and poor quality sleep and can have wide ranging effects on mental and physical health, cognitive and social functioning and development in infants, pre-schoolers, school aged children and adolescents. Each age group have a particular set of behaviourally based sleep disorders. This paper presents a broad overview of BIC and covers essential information about these sleep disorders, their aetiologies, effects on development and non medical treatment modalities

Behavioural treatments to encourage solo sleeping in pre-school children

Behavioural sleep treatments teach children to self soothe and sleep alone but often require a parent to ignore their child’s cries for extended periods, a technique parents may find difficult. This paper presents a modified version of sleep training which aims to improve sleep but reduce crying in children and increase compliance in parents. Thirty-three children (Mean [SD] age = 27.01 [13.4] mths) from a clinical non-controlled population presenting with Behavioural Insomnia of Childhood, utilised a five-week sleep training method that teaches parents to gradually withdraw their assistance, allowing them to attend and calm their child whenever they choose and not to ignore their cries, components that differ from commonly utilised methods. Post treatment, all negative sleep associations, co-sleeping and family stress were reduced and all measures of sleep significantly improved: total night time sleep; time taken until sleep onset (SOL) and minutes awake during the night (WASO) (all p = < 0.002) with large treatment effects sizes (d = 0.94—1.85). Whilst the results are preliminary, this may offer an alternative method to explore in larger studies, given that many parents may have difficulty with ignoring the extended bouts of crying which often accompany commonly utilised sleep training methods

Behavioural sleep interventions in infants: Plan B – combining models of responsiveness to increase parental choice

In families with infants between the ages of 6 and 18 months, sleep disruption can be significant, often putting parents at risk of a range of negative psychological and psychosocial consequences. Commonly prescribed sleep interventions typically involve ‘extinction’ methods, which require parents to completely or periodically ignore their infant's overnight cries. These methods can be effective in many, but not all cases. For over 40 years 30–40% of parents have consistently reported difficulty ignoring their child. For this group, ignoring their child is behaviourally and/or ideologically difficult with attrition often leading to a perceived sense of failure. For these parents the treatment may be worse than the problem. On the other hand, there is emerging evidence to support the use of more responsive methods for those who find extinction approaches behaviourally or ideologically challenging. In this paper we propose an integrated, less polarised approach to infant behavioural sleep interventions that better caters to those who have difficulty with extinction methods – our so-called ‘Plan B’. This approach potentially resolves the often opposing ideological and theoretical perspectives of extinction versus responsiveness into a practical, complementary and pragmatic treatment framework. Recommendations on how best to implement Plan B are also presented. In our view, Plan B could provide practitioners with a logically integrated well-targeted suite of clinical interventions that could potentially improve compliance, reduce attrition and ultimately benefit the sleep and well-being of all infants and their parents, especially those who struggle with traditional extinction methodologies. © 2020 Paediatrics and Child Health Division (The Royal Australasian College of Physicians