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PubMed2000

[Chronic sleep problems--possible to treat?].

Epidemiological studies show that approximately 10% of the population suffer from chronic insomnia. Insomnia can be classified as primary (without any obvious cause) or secondary to other disorders. Non-pharmacological treatment (i.e. sleep restriction, stimulus control treatment) is recommended in chronic primary insomnia, but this kind of treatment is unknown to most Norwegian health-care providers. This paper presents data from such treatment at a sleep disorders centre in Bergen, Norway. Twenty-two patients (10 men, 12 women; mean age 40 years) with chronic primary insomnia were included in the study. They had on average had insomnia for nine years. They went through a structured behavioural treatment regime with sleep restriction and stimulus control as the main components. Median number of consultations was five. The patients completed sleep diaries every week, from two weeks before the treatment started. Weekly averages obtained from the sleep diaries before and after behavioural treatment were statistically evaluated. Total wake time (summation of sleep-onset latency, wake after sleep onset and early morning awakening) was reduced by two hours. Sleep efficiency (total sleep time divided by time in bed) increased significantly from 65% to 86%. Total sleep time and subjective sleep quality also improved. The use of hypnotic medication was significantly reduced. The results indicate that this non-pharmacological treatment is effective in chronic primary insomnia, also in a Norwegian population. There was no control group in this study, and it should be interpreted with caution. However, randomized controlled trials from other countries document the efficacy of sleep restriction and stimulus control treatment in chronic insomnia.

Adult↗
PubMed2004

Using paired-choice assessment to identify variables maintaining sleep problems in a child with severe disabilities.

In this study, we used a paired-choice assessment protocol to identify the relative reinforcing value of stimuli and activities for a child with severe disabilities when she failed to settle to sleep at night. The results of this assessment indicated that the child preferred the mother's attention relative to other activities presented. Assessment results were incorporated into an intervention, that produced a reduction in sleep disturbance that was maintained at a 12-month follow up.

Child, Preschool↗