A randomised controlled trial of cognitive-behaviour therapy for behavioural insomnia of childhood in school-aged children

May 10, 2011Behaviour research and therapy

Cognitive-behavior therapy for childhood sleep problems in school-aged children: a randomized controlled trial

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Abstract

Children receiving cognitive-behaviour therapy (CBT) showed significant improvements in sleep latency, wake after sleep onset, and sleep efficiency compared to waitlist controls.

42 children aged 7 to 13 years were evaluated for Behavioural Insomnia of Childhood.
CBT included 6 sessions that combined techniques for managing sleep and anxiety.
Significant improvements were noted in problematic sleep associations and child-reported anxiety.
All observed gains in sleep and anxiety symptoms were maintained 6 months after treatment.
Total sleep time did not show significant changes with CBT.

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Chronic sleep problems can lead to the development of Behavioural Insomnia of Childhood - a sleep disorder involving problematic sleep-onset associations (i.e., parental presence), and resulting in impairments for children and family members. The aim of the present paper was to perform a controlled evaluation of cognitive-behaviour therapy (CBT) for Behavioural Insomnia. 42 children (M = 9.3 ± 1.9 yrs, range 7-13 yrs, 18f, 24 m) were randomised to CBT (N = 21) or waitlist control (N = 21). CBT consisted of 6 sessions, and combined behavioural sleep medicine techniques (e.g., sleep restriction) with anxiety treatment techniques (e.g., cognitive restructuring). Compared to waitlist controls, children receiving CBT showed significant improvements in sleep latency, wake after sleep onset, and sleep efficiency (all p ≤ .003), but not total sleep time (p > .05). CBT was also associated with a reduction in problematic sleep associations (p ≤ .001), child-reported total and separation anxiety (both p ≤ .01), with all gains being maintained 6 months post-treatment. This is the first controlled study to demonstrate that multi-component CBT can be effective for the sleep, insomnia, and anxiety symptoms of Behavioural Insomnia of Childhood in school-aged children. Future research is needed to ascertain active treatment components.

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A randomised controlled trial of cognitive-behaviour therapy for behavioural insomnia of childhood in school-aged children

Abstract

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