Behavioral Insomnias of Childhood: Assessment and Treatment

Abstract

The Behavioral Insomnias of Childhood (BIC) include a series of problems of sleep initiation, continuity, maintenance, and bedtime resistance. These sleep problems can place a significant burden on the parents who may be required to attend to a child at the beginning or in the middle of the night. The resulting sleep loss can impact parents’ and children’s daytime functioning and can increase bedtime-related conflict. Even when sleep problems do not meet criteria for a disorder, they can increase parental stress and parent–child conflict. Childhood sleep problems can be an indicator of poor regulatory capacity in the infant or child, and there is some evidence that sleep problems presenting in the first few years of life can be a marker of a diathesis for psychopathology. Even though sleep problems in early childhood are quite common and there are well-established interventions for these problems, little is understood about the pathophysiology of childhood sleep disorders. This chapter will review common causes of sleep problems in infants and young children that can persist into the later school years and adolescence. This will be followed by a detailed practical approach to evaluating and treating childhood insomnias.