Behavioral insomnia in infants and young children

Abstract

In infants and young children, bedtime problems and night waking are common and the main presentations of insomnia. Poor sleep may critically impact the daytime functioning and mood of the child and their caregivers. A comprehensive sleep history, a sleep diary/log, and the BEARS (Bedtime problems, Excessive daytime sleepiness, Awakenings during the night, Regularity and duration of sleep, and Sleep-disordered breathing) sleep screen are useful for diagnosing sleep problems in young children. Behavioral therapies for this type of insomnia include extinction, bedtime fading with positive routines, and scheduled awakening. Previous studies of behavioral interventions for young children showed significant improvements in sleep-onset latency, night waking frequency, and night waking duration. Parent education about their child's sleep, bedtime routines, and sleep hygiene is essential for treatment.

Keywords: Behavioral intervention; Insomnia; Pediatric; Sleep.

Fig. 1.

This is a sample sleep log that was recorded for a 13-month-old baby with behavioral insomnia. The thick lines indicate the time of sleep, and check mark shows the time when the baby awakened during sleep. Note the irregular napping from 10 AM to 8 PM. (Courtesy of Professor Kyu Young Chae/CHA Bundang Medical Center, CHA University)