[Childhood insomnia due to disorderly habits].
A common disorder in children aged between 6 months and 5 years is childhood insomnia due to disorderly habits. The clinical characteristics of this condition are difficulty in going to sleep on their own and multiple nocturnal wakenings. It occurs in perfectly normal children who are seen to have difficulty in the normalization of their sleep-waking rhythm due to absence or weak application of external synchronizers. The only point on which we can act to enforce synchronization of the sleep-waking circadian rhythm is on the habits related to getting to sleep. To initiate this synchronization of sleep-waking rhythm, it is essential to create a ritual around the action of going to bed. The possibility of the child getting back to sleep during the many physiological wakenings he has during the night depends on this ritual. It is essential that the child be awake when he leaves the bedroom. The child must learn to go to sleep with external elements which are associated with sleep, and during the physiological wakenings during the night, he will reclaim the circumstances which he associates with sleep. If the child goes to sleep on his own, he will go back to sleep on his own when he wakes at night; but if he has gone to sleep in someone's arms or 'has been put to sleep' by rocking, he will want the arms or rocking again. Once the routine is completed, the parents will leave the room and should follow a pattern of waiting time, increasing his progressively, following techniques for the modification of conduct until the child manages to get to sleep on his own.
Estivill
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Unidad del Sueño, Institut Universitari Dexeus, Barcelona, España. estivill@ctv.es
D001521:Behavior Therapy / Q000379:methods; D002675:Child, Preschool; D002940:Circadian Rhythm / Q000502:physiology; D005260:Female; D006184:Habits; D006801:Humans; D007223:Infant; D008297:Male; D010507:Periodicity; D007319:Sleep Initiation and Maintenance Disorders / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D014851:Wakefulness / Q000502:physiology