Treatment of sleep problems in families with young children: effects of treatment on family well-being.

AIM: To evaluate a standardized sleep programme that is a two-step variation of graduated extinction, where the child is first taught to fall asleep by him/herself at bedtime (first intervention) and two weeks later also after night awakenings (second intervention). As it has been claimed that extinction procedures may be harmful to the child, this study documents both night- and daytime behaviour before and after interventions. METHOD: The study included a total of 95 families, with children from 4 to 45 mo of age exhibiting frequent signalled awakening episodes during the night. Sleep diaries, visual analogue scales (VAS) on daytime behaviour and the Flint Infant Security scale, completed by parents, were used as instruments. Parents also completed VAS scales and the Swedish Parenthood Stress Questionnaire scales on their own well-being. RESULTS: All families carried out the interventions. Parents reported significant improvements in sleep quality, daytime behaviour and family well-being as early as two weeks after the first intervention. Before intervention, the sleep-disturbed children were rated as more insecure than a matched comparison group with unknown sleep behaviour. This difference was eliminated after the interventions. The more anxious the children were rated before intervention, the more they tended to benefit from it. CONCLUSION: If parents experience young children's night awakenings as a problem, teaching the children to fall asleep by themselves usually solves this problem quickly. According to parental ratings, family well-being and negative daytime behaviour are also improved.

Treatment of sleep problems in families with small children: is written information enough?

UNLABELLED: The aim of this study was to evaluate a standardized sleep programme, i.e. a two-step variation of graduated extinction, where the child is first taught to fall asleep by him/herself at bedtime (first intervention) and 2 wk later also after night wakings (second intervention). The outcome after consultations with a therapist followed by telephone support during both interventions was compared with the outcome after giving written information only during the first intervention and therapist support during the second. A total of 67 families with infants exhibiting spontaneous awakening and crying episodes during the night were randomly assigned to either programme. There were no significant differences in terms of outcome between the two groups. In both groups the number of registered night wakings decreased immediately following the first intervention. At registration, at 1 mo and 3 mo later, all parents, with the exception of one couple at the 3-mo follow-up, reported that the sleep problem had improved. CONCLUSION: If parents experience their infant's night awakenings as a problem, teaching their infant to fall asleep by him/herself usually solves this problem quickly. Written information is in most cases sufficient to help parents introduce the new evening routines.