Childhood insomnia is estimated to occur in 20 to 30% of infants, toddlers, and preschoolers. If untreated, approximately 80% will continue to experience problems with falling or staying asleep when followed three years later. It not only results in significant problems such as irritability, inability to get up for school and learning problems, but also has been associated with parental consequences such as sleep deprivation, maternal depression, and marital problems.
Insomnia in children usually presents either with a refusal to go to bed known as Limit Setting Insomnia or frequent awakenings requiring the parent’s presence to return to sleep, referred to asSleep Onset Association Insomnia.
There are several strategies available to deal with this problem. The first is to develop a set sleep/wake schedule for your child and stick to it. A calming bed time routine that includes bathing, dressing for sleep, and a bedtime story can be helpful. Eliminating television and vigorous physical activities near bedtime is also important. Putting your child to bed when drowsy and not asleep is important for your child to develop self-soothing skills that will help them to fall asleep.
If this fails, there are several other behavioral techniques. One called unmodified extinction, also called “crying it out,” entails putting your child to bed and not responding to their cries or pleadings. Another called “camping out,” is much the same but you stay in the room. Most parents find this very hard to do, but a recent study published in the journal Pediatrics that followed children for up to five years found no adverse physical or emotional consequences when these techniques were used. Another more gentle technique called graduated extinction involves you responding at ever-increasing time intervals nightly. An example might entail responding to the child’s crying at five minute intervals the first night and increasing this by five to ten minutes on successive nights. Another technique involves delaying bedtime in order to increase the likelihood of the child’s falling asleep on their own. Once accomplished, bedtime is slowly advanced back to a more appropriate time.
The idea behind all of these techniques is to avoid rewarding negative sleep behaviors while reinforcing the positive behavior of allowing children to put themselves to sleep. Early intervention can result in a better night’s sleep for both you and your child.
