Sleep difficulties

November 09, 2016

Research has shown that sleep is vital for all aspects of physical and mental health. In adults, sleep deprivation can cause fatigue, poor concentration, memory difficulties, mood disturbances, impaired judgment and slowed reaction times. In children, sleep deprivation often increases hyperactivity and aggression, and impairs mood and cognitive functioning.

There are many causes of short-term or long-term sleep difficulties. Common triggers include school pressure, family problems, anxiety and stress. Environmental factors such as high-sugar beverages, exercising close to bedtime, following an irregular morning and night time schedule and performing mentally intensive activities before or after getting into bed can also disrupt sleep. One of the biggest factors that disrupts sleep is technology including the use of iPads, mobile phones and computers. Research has shown that reading a backlit device before bed makes sleep measurably worse than reading a paper book under a dim light.

Treatment of sleep problems in children

Research evidence shows that the long-term benefits of non-medication treatments (such as Cognitive Behavioural Therapy; CBT) for insomnia are superior to those of medication. The American Association of Sleep Medicine (AASM) 2008 guideline recommends CBT as the most appropriate treatment for patients with primary insomnia as insomnia is associated with emotional, physiological and cognitive factors, and learning to be awake when in bed.

Sleep Hygiene 
The first step of treatment for insomnia and sleep disturbance is to identify and address any factors which may be interfering with sleep, as well as introducing behaviours which may enhance sleep. These include:

  • Reducing caffeine intake, particularly in the afternoon
  • Eliminating the use of backlit devices for at least an hour before bed
  • Exercising during the day (but not close to bedtime)
  • Having a regular bedtime routine
  • Eliminating clock-watching
  • Having a warm bath an hour before bedtime
  • Ensuring the bedroom environment is conducive to sleep (e.g., cool, dark, quiet)

Cognitive therapy
The aim of cognitive therapy in helping children with sleep difficulties is to identify and address thoughts that interfere with sleep. Some children for example, worry about never sleeping well again; others worry about what will happen if they fall asleep. Such styles of thinking at bedtime are likely to impede ability to fall asleep, at least in part because of the chemicals our bodies release when we are anxious, to get us ready to take action! Identifying unhelpful thoughts, and learning to think more helpfully about sleep, can have a substantial impact on your childs ability to fall asleep and stay asleep.

Behaviour therapy

The aim of behaviour therapy is to break down some of the avoidance and safety behaviours using a graded approach. For example; some children cannot fall asleep without their parents assistance. The goal of behaviour therapy would be to fade the parent out of the bedtime routine and promote independent sleep habits.

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