Sleep Difficulties

Definition of Sleep Difficulties:

Sleep problems are common in children with between 25–40% of youth experiencing sleep difficulties such as sleep anxiety, insomnia, frequent waking, delayed circadian rhythm, or night terrors at some point during childhood or adolescence. More than a third of American adults are not getting enough sleep on a regular basis, according to a new study in the Centers for Disease Control and Prevention’s (CDC) Morbidity and Mortality Weekly Report (2016). 

Untreated sleep problems can lead to excessive daytime sleepiness, hyperactivity/behavioral problems, moodiness/irritability, as well as concentration/attention difficulties and in turn often affect functioning across a variety of domains including academic, occupational, behavioral, and social.  Sleep disruption often co-occurs with anxiety and depression. Common problems also include difficulty falling asleep, waking up at night, or waking up early. Over time, many also develop sleep-related anxiety.

Sleep related symptoms include:

  • Nighttime fears
  • Bedtime refusal
  • Difficulty falling asleep alone
  • Difficulty sleeping through the night
  • Nightmares
  • Poor sleep habits
  • Sleep terrors
  • Excessive bedtime routines

Sleep disruption treatment:

Cognitive-behavioral therapy (CBT) has been shown to be the most effective non-medical treatment for insomnia in several studies. CBT is an effective, evidence-based treatment for sleep difficulties. Treatment includes assessment of sleep behaviors and related history, monitoring of sleep habits, alteration of sleep habits and environmental interference, implementation of an individually tailored sleep schedule based on current sleep patterns, and addressing disruptive beliefs about sleep.

Cognitive interventions help individuals learn strategies to recognize, modify or eliminate unhelpful/negative thoughts or worries that interfere with their ability to sleep. Behavioral interventions also can include graduated extinction, parent education, and positive bedtime routines.

Cognitive Behavior Therapy-Insomnia (CBT-I) is an effective treatment program that has been proven to alleviate sleeping problems. This treatment program is often recommended to insomnia patients as the first line of therapy. CBT-I controls and eliminates worries and thoughts that always keep you awake. It also includes stimulus control techniques, which helps associate that the bed is used for sleep and intimacy only. If you cannot get sleep within the first twenty minutes of getting to bed, you might need to leave the bedroom and return when you are tired again. Another CBT-I technique called sleeping restrictions recommends that you do not lie in bed when you are awake. The habit of lying in bed without sleeping can lead one to be conditioned to experience inadequate sleep. Sleep restriction reduces the time spent in bed, which in turn causes partial sleep deprivation which can make you more tired and ready for a deep nights sleep.

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