As a psychologist with a special interest in sleep, interesting projects sometimes come my way. One of these recently came to fruition in the form of a chapter in the newly published Oxford Handbook of Sleep Medicine, edited by Guy Leschziner. I am very grateful to Guy for the invitation to contribute.
My chapter covers presentations of insomnia across the childhood age range, and ways to treat them. At present the synopsis is incorrect and the correct one is as follows:
Various behavioural approaches have been shown to ameliorate sleep in children who have difficulties with initiating sleep and getting back to sleep during the night. The fundamentals of these techniques are the same irrespective of the underlying health or environmental concerns. Essential foundations of good sleep include consistent sleep timings with a nightly pre-bed wind-down routine, which is maintained at weekends and during school/nursery holidays, and age-appropriate bedtimes. This chapter focusses mainly on behavioural interventions to address unhelpful sleep associations that younger children might develop, leading them to “need” parental presence in order to initiate sleep, and following night wakings. Behavioural interventions depend on caregiver engagement; habit change is effortful for all involved. Central to assessment should be clarifying goals of the child (if possible) and their caregivers. Patients (and their families) and clinicians can hold differing beliefs about ideal sleep, owing to societal, cultural and familial influences. Beliefs about medications can also play a role: some people would prefer the change be effected via medication than take a more active role in behavioural change. Motivational interviewing can support this process, and SMART (specific, measurable, attainable, reasonable and time-based) goals should be established.
You can access the book for free from an NHS-connected computer:
I also did a Q & A session with The Sleep Charity later in the week, as part of their sleep practitioner training. There were some excellent questions from the delegates, including one about sleep disruption in children who are on the autistic spectrum. Since questions in relation to this come up a lot, here’s a link to my ACAMH session on Autism and Sleep in Children.
