Research into treatment for sleep disorders

A systematic review of treatment for children with sleep disorders has been carried out by researchers at the University's Section of Child and Adolescent Psychiatry. The study, published in the British Medical Journal in January, emphasises the high rate of sleep disorders in young children—about 20 per cent of children aged 1–3 years experience some disturbance—and draws attention to the effects of continual sleep disruption, which is associated with behavioural difficulties in the children affected, maternal ill-health, and impaired parent–child relationships. It compares the long and short-term effectiveness of various interventions from medication to different behavioural approaches. The review demonstrates that, although sedation is currently the most common form of treatment for sleep disturbances, both its short and long-term efficacy is questionable. A significant number of children show an improvement in symptoms following administration of medication but many continue to wake at night, and up to one-third show no improvement at all. Follow-up of the families after the drug treatment had ended indicated that sleep problems remained in most children. Behavioural treatments showed more positive results and were overall more acceptable to parents, many of whom withdrew their child from drug studies. Treatments reviewed included the establishment of consistent bedtime routines, letting the child cry, and individually tailored sleep programmes with daily support for parents by means of telephone calls from health-care workers. The review forms part of the Section's programme of research into childhood sleep disorders, headed by Professor Gregory Stores. Current projects include sleep disorders in children with autism or Attention Deficit Hyperactivity Disorder (ADHD), preventive and intervention studies with children with learning disabilities including children with Down's Syndrome, and the psychosocial effects of excessive sleepiness, for example that caused by narcolepsy. Dr Luci Wiggs, Research Psychologist in the Section, said: `Recent national surveys we have conducted suggest that generally in the UK, as in the rest of Europe, training about sleep and its disorders is limited both for medical staff and psychologists. This is particularly alarming given both the widespread occurrence of sleep problems at every age and the association between sleep disturbance and impaired daytime functioning. It is also unfortunate since the majority of sleep problems, if properly assessed and diagnosed, can be treated effectively.'