Behavioural treatments to encourage solo sleeping in pre-school children: An alternative to controlled crying

Abstract

Behavioural sleep treatments teach children to self soothe and sleep alone but often require a parent to ignore their child’s cries for extended periods, a technique parents may find difficult. This paper presents a modified version of sleep training which aims to improve sleep but reduce crying in children and increase compliance in parents. Thirty-three children (Mean [SD] age = 27.01 [13.4] mths) from a clinical non-controlled population presenting with Behavioural Insomnia of Childhood, utilised a five-week sleep training method that teaches parents to gradually withdraw their assistance, allowing them to attend and calm their child whenever they choose and not to ignore their cries, components that differ from commonly utilised methods. Post treatment, all negative sleep associations, co-sleeping and family stress were reduced and all measures of sleep significantly improved: total night time sleep; time taken until sleep onset (SOL) and minutes awake during the night (WASO) (all p = < 0.002) with large treatment effects sizes (d = 0.94—1.85). Whilst the results are preliminary, this may offer an alternative method to explore in larger studies, given that many parents may have difficulty with ignoring the extended bouts of crying which often accompany commonly utilised sleep training methods.