Childhood insomnia, a disorder that “upsets a lot”

Childhood insomnia is included in the sleep disorders and affects between 20-30% of the child population up to preschool age. It is characterized by the difficulty the child has in falling asleep independently. It is also characterized by nocturnal awakenings with inability to go back to sleep. If the child resists going to bed at night at the stipulated time, it can also be a symptom of insomnia.

Why does childhood insomnia occur?

The etiology of childhood insomnia is multifactorial (biological, medical, circadian, neurodevelopmental, behavioral causes) and there are also predisposing factors, which should be analyzed by the specialist in Neurophysiology and Sleep Medicine with a functional analysis, in order to establish an accurate diagnosis. About 10% are medical causes (allergies, intolerances, reflux, atopias, etc.), but the rest, 90% are behavioral causes, i.e., absence of sleep habits or routines.

In addition, there are studies that show a close relationship between childhood insomnia and depression in mothers. Other studies show that childhood insomnia can continue into preschool and school age and even become chronic if proper treatment is not applied in time.

What causes childhood insomnia in the child and family?

It has been shown that childhood insomnia seriously affects the child during the day, in terms of mood, cognitive, behavioral, health and quality of life. In addition, it causes family dysfunction and even has an impact on the quality of life and mood of the parents.

Ways of treatment for childhood insomnia

The treatment of childhood insomnia will depend on the cause of the insomnia. It will be essential to establish a correct diagnosis before starting treatment. Childhood insomnia can respond to medical causes (10% of cases) (food intolerances, gastroesophageal reflux …), sleep disorders (Restless Legs Syndrome, apneas …) or psychological (anxiety, fears, etc). and the remaining 90% is due to lack of sleep habits and routines.

In childhood insomnia due to incorrect habits the treatment is based on behavioral interventions, based on principles of behavioral psychology. This type of psychology is part of a framework of commitment to the scientific method which implies that interventions must be empirically evaluable. This means that interventions are based on the assumption that behaviors and cognitions are amenable to modification by controlling those reinforcers that maintain them.

Read Now 👉  Useful tips for a better rest

In general, three large groups of children with insomnia can be distinguished, distinguished by age. The first group comprises children from 6 months to 5 years of age. The second group includes children between 6 and 12 years of age and, finally, the group of adolescents. The forms in which insomnia presents itself are similar in all age groups (insomnia of conciliation and/or maintenance), but the way of dealing with it is different. Thus, in younger children the behavioral guidelines are taught to parents, so that they know how to apply them to their children, and are based on “extinction” techniques. In children between 6 and 12 years of age, the child’s collaboration is necessary and therapeutic strategies (non-pharmacological) will be based on positive reinforcement, distraction techniques and paradoxical intention, in addition to cognitive restructuring. However, in the case of adolescents, it is important to pay attention to circadian rhythm disturbances, which will respond well to chronotherapy, although specialists should be alert to the possibility of insomnia secondary to anxiety or mood disorders.

According to a very comprehensive meta-analysis review conducted by the American Academy of Sleep Medicine, behavioral interventions produce reliable and lasting changes. In this regard, 94% of the studies demonstrate that behavioral interventions are effective, more than 80% of treated children show clinical improvements that are maintained beyond 3-6 months, and no unwanted side effects are noted in any of the studies reviewed.