What are the behavioral insomnias of childhood?

Updated: Sep 11, 2018
  • Author: Jasvinder Chawla, MD, MBA; Chief Editor: Selim R Benbadis, MD  more...
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Answer

A child's symptoms meet the criteria for insomnia based on parents’ or other adult caregivers’ observations. Two types of this sleep disturbance are recognized: sleep-onset association and limit-setting.

The sleep-onset association type is characterized by the following:

  • Falling asleep is an extended process that requires special conditions
  • Sleep-onset associations are highly problematic or demanding
  • In the absence of associated conditions, sleep onset is significantly delayed or sleep is otherwise disrupted
  • Nighttime awakenings require caregiver intervention for the child to return to sleep

The limit-setting type is characterized by the following:

  • The child has difficulty initiating or maintaining sleep
  • The child stalls or refuses to go to bed at an appropriate time or refuses to return to bed following a nighttime awakening
  • The caregiver demonstrates insufficient or inappropriate limit-setting to establish appropriate sleeping behavior in the child

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