The incidence of sleep problems in children varies depending on age, but is usually between 25-50%. When insomnia becomes chronic, daytime sleepiness, restlessness, irritability, behavioral problems, learning difficulties, decrease in academic success and increase in accidents are observed. To prevent these problems, families need to establish good sleep habits from infancy and need to ensure continuity. The American Association of Pediatrics states that all pediatricians should ask whether the child has any sleep problems during routine well-child examinations. If we can`t set up good sleep habits, “behavioral insomnia”  may occur.

Behavioral Insomnia:

It is the learned inability of children/infants to fall asleep or stay asleep. In America, it has been reported that children in this group have a rate of 10-30% of all sleep disorders. Children with behavioral insomnia can be divided into 2 subgroups:

  1. Having trouble in to fall asleep
  2. Could not set up limits
  3. Trouble going to sleep: Children in this group have an inability or reluctance to fall asleep or go back to sleep when they wake up. They cannot fall asleep without a certain situation or action. For example, in the infancy age group, the child cannot sleep unless conditions such as rocking, feeding, holding mom`s hair… etc., and in the preschool age group, co-sleeping with parents, feeding at night.
  4. Problem of Setting Limits: If families have problems setting limits for their children, we encounter this situation. For example, if the child does not have a specific bedtime and wake-up time, if the family allows him/her to go to bed late, watch TV, sleep wherever he wants, or if he keeps waking up to drink, to go to washroom, then sleep problems arise. This condition is more common in the preschool age group.

The best treatment for behavioral sleep problems is prevention. In other words, before the problem arises, family physicians and pediatricians should provide training to parents at well-baby follow up about setting limits, making sleep routines and schedules.

If we are facing with a behavioral sleep problem, a treatment plan should be made according to child’s age, problem and family priorities. There are three common methods used around the world to solve sleep problems:

  • Ferber Method
  • Tracy Hogg Method
  • Kim West Method

The aim of all three of these methods is to enable the child to sleep by himself and fall asleep again when he wakes up, and to reduce the frequency of waking up at night. Different methods and treatment plans can be applied depending the child`s and family’s needs. Most of the time, the problem can be solved by simply paying attention to sleep principles.

Dr. Gulben EFES