title: Managing sleep disorders in children: which is the best strategy?
abstract: This review aims to critically analyze the literature studies showing the effectiveness of cognitive-behavioral strategies in the treatment of sleep disorder during the developmental age. About 15-35% of children suffer from sleep disorder. If they are not treated right away, it can persist into adulthood. Recent studies demonstrate an effective cognitive-behavior treatment for these disturbances. In this regard, the most effective method seems to be extinction (standard, with parental presence, graduated), the bedtime routine, scheduled awakenings, and preventive parent education. The procedures of extinction, not only its effectiveness, have limited application for the difficulty that compares to the parents following the procedure of the intervention. They are not able to ignore their children when they are crying for long prolonged period of time. Bedtime routine is relevant in the prevention and treatment of sleep disorders. The scheduled awakenings are a useful technique that teaches parents to change the way they interact with the child's disturbed sleep, allowing recovery. Finally, preventive parental education depends on the parents or caregivers and aims to educate them; during the prenatal or postnatal period with their child's sleep it seems useful in preventing irregular pattern formation and temporal regulation of sleep. The vast majority of children's sleep disruptions seem to resolve only with the cognitive-behavioral intervention, while in some psychopathologic disruptions it is necessary to combine cognitive-behavioral and drug therapy. Literature reviews show that clinical research concerning sleep disruptions is still very limited. In current reviews, there have been diverse investigations on efficacy of cognitive-behavioral interventions and sleep disruptions, highlighting both the strong points and weak points. Therefore, this analysis could be a starting point for developing further research since there is a lack of studies in relation to evidence-based interventions and specific therapeutic factors for each intervention and disturbance.
authors.affiliation: University of Rome, Department of Pediatrics, Italy.
authors.forename: Benedetta
authors.initials: B
authors.lastname: Bellini
authors.forename: Oliviero
authors.initials: O
authors.lastname: Bruni
authors.forename: Alessandra
authors.initials: A
authors.lastname: Cescut
authors.forename: Silvia
authors.initials: S
authors.lastname: De Martino
authors.forename: Franco
authors.initials: F
authors.lastname: Lucchese
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Guidetti
mesh_terms: D002648:Child; D002675:Child, Preschool; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D020920:Dyssomnias / Q000628:therapy; D005108:Extinction, Psychological; D006801:Humans; D020447:Parasomnias / Q000628:therapy; D010290:Parents / Q000193:education / Q000523:psychology; D012893:Sleep Wake Disorders / Q000628:therapy*