BMJ 2000;320:209-213 ( 22 January )

Papers

A systematic review of treatments for settling problems and night waking in young children

Paul Ramchandani, research registrar, ^a Luci Wiggs, research psychologist, ^a Vicky Webb, general practitioner, ^b Gregory Stores, professor. ^a

^a University of Oxford Section of Child and Adolescent Psychiatry, Park Hospital for Children, Headington, Oxford OX3 7LQ, ^b Florence Nightingale House, Aylesbury, HP21 8AL

Correspondence to: P Ramchandani, Child and Family Psychiatry Service, Sue Nicholls Centre, Manor House, Aylesbury, Buckinghamshire HP20 1EG paulgulab{at}aol.com

Objectives: To assess the efficacy of treatments for settling problems and night waking in young children.
Design: A systematic review of randomised controlled trials of interventions for settling problems and night waking in young children.
Setting: Electronic bibliographic databases and references on identified papers, hand searches, and personal contact with specialists.
Subjects: Children aged 5 years or less who had established settling problems or night waking.
Interventions: Interventions had to be described and a placebo, waiting list, or another intervention needed to have been used as a comparison. Interventions comprised drug trials or non-drug trials.
Main outcome measures: Number of wakes at night, time to settle, or number of nights in which these problems occurred.
Results: Drugs seemed to be effective in treating night waking in the short term, but long term efficacy was questionable. In contrast, specific behavioural interventions showed both short term efficacy and possible longer term effects for dealing with settling problems and night waking.
Conclusions: Given the prevalence and persistence of childhood sleep problems and the effects they can have on children and families, treatments that offer long lasting benefits are appealing and these are likely to be behavioural interventions.

---

© BMJ 2000
CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

Relevant Articles

Treating children with sleep disorders

Mary Fay, Zan Buckner, Brian Symon, John Marley, James Martin, Dieter Wolke, Luci Wiggs, Gregory Stores, Paul Ramchandani, and Vicky Webb
BMJ 2000 320: 1667. [Extract] [Full Text]

Behavioural treatment may help solve childhood sleep problems
BMJ 2000 320: 0. [Full Text]

This article has been cited by other articles:

• Hiscock, H., Bayer, J., Gold, L., Hampton, A., Ukoumunne, O. C, Wake, M. (2007). Improving infant sleep and maternal mental health: a cluster randomised trial. Arch. Dis. Child. 92: 952-958 [Abstract] [Full text]  
• Heneghan, C. (2005). Practice corner: The doctor's advice and sleepless nights: what can you find in 5 minutes?. Evid. Based Med. 10: 36-38 [Full text]  
• Touchette, E., Petit, D., Paquet, J., Boivin, M., Japel, C., Tremblay, R. E., Montplaisir, J. Y. (2005). Factors Associated With Fragmented Sleep at Night Across Early Childhood. Arch Pediatr Adolesc Med 159: 242-249 [Abstract] [Full text]  
• Montgomery, P, Stores, G, Wiggs, L (2004). The relative efficacy of two brief treatments for sleep problems in young learning disabled (mentally retarded) children: a randomised controlled trial. Arch. Dis. Child. 89: 125-130 [Abstract] [Full text]  
• Ramchandani, P., Jones, D. P. H. (2003). Treating psychological symptoms in sexually abused children: From research findings to service provision. Br. J. Psychiatry 183: 484-490 [Abstract] [Full text]  
• Stores, G (2003). Medication for sleep-wake disorders. Arch. Dis. Child. 88: 899-903 [Abstract] [Full text]  
• Owens, J. A., Rosen, C. L., Mindell, J. A. (2003). Medication Use in the Treatment of Pediatric Insomnia: Results of a Survey of Community-Based Pediatricians. Pediatrics 111: e628-635 [Abstract] [Full text]  
• Lam, P., Hiscock, H., Wake, M. (2003). Outcomes of Infant Sleep Problems: A Longitudinal Study of Sleep, Behavior, and Maternal Well-Being. Pediatrics 111: e203-207 [Abstract] [Full text]  
• Nikolopoulou, M, St James-Roberts, I (2003). Preventing sleeping problems in infants who are at risk of developing them. Arch. Dis. Child. 88: 108-111 [Abstract] [Full text]  
• Lucas, P., Liabo, K., Roberts, H. (2002). Do behavioural treatments for sleep disorders in children with Down's syndrome work?. Arch. Dis. Child. 87: 413-414 [Full text]  
• Minde, K. (2000). Review: long term effectiveness of non-drug treatments for sleep problems in young children is more evident. Evid. Based Med. 5: 148-148 [Full text]  
• Minde, K. (2000). Review: drug and non-drug treatments are effective in settling problems and night waking in young children but the long term effectiveness of non-drug treatments is more evident. Evid. Based Ment. Health 3: 86-86 [Full text]  
• Fay, M., Buckner, Z., Symon, B., Marley, J., Martin, J., Wolke, D., Wiggs, L., Stores, G., Ramchandani, P., Webb, V. (2000). Treating children with sleep disorders. BMJ 320: 1667-1667 [Full text]  
• (2000). Helping Children Sleep Through the Night. JWatch Psychiatry 2000: 21-21 [Full text]  
• (2000). Helping Children Sleep Through the Night. JWatch General 2000: 6-6 [Full text]  

Rapid Responses:

Read all Rapid Responses

Kids don't get any respect.

Mary Fay
bmj.com, 21 Jan 2000 [Full text]

Do not discard proper drug treatments in young children

Salvador Vale
bmj.com, 22 Jan 2000 [Full text]

When to treat sleeping problems

Dieter Wolke
bmj.com, 22 Jan 2000 [Full text]

Quality Ratings of Behavioural Trials

Dieter Wolke
bmj.com, 23 Jan 2000 [Full text]

Ignoring Biology

Zan Buckner
bmj.com, 22 Jan 2000 [Full text]

Treatments for settling problems and night waking in young children

Malcolm Cooper
bmj.com, 25 Jan 2000 [Full text]

Some children have "regulatory disturbances"

Martin Maldonado-Duran
bmj.com, 30 Jan 2000 [Full text]

A natural treatment.

J W Tankel, et al.
bmj.com, 4 Feb 2000 [Full text]

The prevention of infant sleep disturbance

Brian Symon
bmj.com, 21 Feb 2000 [Full text]