Abstract
Insomnia is a sleep disorder characterized by difficulty falling asleep, staying asleep, or both. Insomnia presents variably in children and adolescents, both in terms of symptoms and contributory factors. This chapter describes the prevalence, incidence, and identification through assessment, clinical interviews, sleep logs, ratings scales, and objective measures. Identifying applicable contributory factors for a specific child is a critical conceptual approach in treatment planning. Effective interventions for insomnia operate on principles of behaviorism, cognitive theory, and sleep physiology. Treatment may involve establishing contingencies around parental attention such that a child receives positive reinforcement for a desired behavior (e.g., cooperating with a bedtime routine; staying in bed quietly) and minimal attention for behaviors that may inhibit sleep (e.g., getting out of bed after bedtime). Strategies to promote behavioral change, such as self-monitoring, behavioral contingencies, and identifying replacement behaviors, can be applied to promote more adaptive sleep habits. Treatment efficacy studies have focused on interventions for bedtime problems and night wakings in young children, supporting extinction-based treatment approaches. The authors describe a menu of behavioral sleep treatment components. Treatment approaches for pediatric insomnia are often brief and effective, with resolution of symptoms in just a few sessions.
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Honaker, S.M., Meltzer, L.J. (2020). Evidence-Based Interventions for Sleep Problems and Disorders. In: Steele, R.G., Roberts, M.C. (eds) Handbook of Evidence-Based Therapies for Children and Adolescents. Issues in Clinical Child Psychology. Springer, Cham. https://doi.org/10.1007/978-3-030-44226-2_16
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