Insomnias of Childhood: Assessment and Treatment
Insomnia in childhood includes difficulty initiating and maintaining sleep and bedtime resistance. These sleep problems are common in childhood and largely result from interactions between the caregivers or parents and their children. However that are oth
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Insomnias of Childhood: Assessment and Treatment Daniel S. Lewin and Edward Huntley
Abstract Insomnia in childhood includes difficulty initiating and maintaining sleep and bedtime resistance. These sleep problems are common in childhood and largely result from interactions between the caregivers or parents and their children. However that are other causes and origins of insomnia that can include child temperament, psychopathology, or variation in sleep need that can include decreased need for sleep and atypical circadian regulation. Chronic insomnia symptoms often precipitate a range of functional daytime impairments (e.g., academic impairment, hyperactivity, inattention, irritability, tiredness) which may further undermine subsequent parent–child interactions including the transition to sleep. Evidence-based interventions for childhood insomnia can address these sleep difficulties and family stress. However, dissemination of evidence-based interventions is limited by the dearth of clinicians trained to deliver these interventions, access to sleep disorder centers, and cost. This chapter provides an overview of approaches to diagnosis and management of childhood insomnia. Keywords Cognitive-behavioral therapy (CBT) • Insomnia • Evidence-based practice • Child • Parent–child relations • Sleep initiation • Maintenance
D.S. Lewin, Ph.D. (*) Department of Pulmonary and Sleep Medicine, Children’s National Medical Center, George Washington University School of Medicine, 111 Michigan Avenue, N.W, Washington, DC 20010, USA e-mail: [email protected] E. Huntley, Ph.D. Survey Research Center, Institute for Social Research, University of Michigan, 426 Thompson St., Ann Arbor, MI 48106-1248, USA e-mail: [email protected] © Springer International Publishing Switzerland 2017 H.P. Attarian (ed.), Clinical Handbook of Insomnia, Current Clinical Neurology, DOI 10.1007/978-3-319-41400-3_8
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D.S. Lewin and E. Huntley
Introduction The insomnias of childhood include bedtime resistance, sleep initiation sleep, and maintenance problems. These bedtime and sleep problems can place a significant burden on caregivers and parents who may be required to spend significant time attending to a child at the beginning or middle of the night and sometimes early in the morning. The resulting sleep loss can impact parents’ and children’s daytime functioning and increase bedtime-related conflict and influence family dynamics [1]. Even when sleep problems do not meet criteria for a disorder, they are a common cause of stress in parent–child relationships. Childhood sleep problems can be an indicator of poor regulatory capacity in the infant or child, and there is evidence that sleep problems presenting in the first few years of life can be a marker of a diathesis for psychopathology and health problems [2–5]. Even though sleep problems in early childhood are quite common and there are well-established interventions for these problems, little is understood about the etiology pathophysiology of childhood sleep disorders. This chapter reviews common ca
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