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Pediatric Sleep Disorders > Infant and Pediatric Sleep Complaints
BEDTIME PROBLEMS
After a long day at work, caring for your children, household duties, and the demands of managing a family most parents look forward to the evening where they can put their children to bed and have a little “me” time. However, if you find yourself arguing with your child about getting ready for bed, getting into bed, dealing with requests for one more hug or one more trip to the bathroom, or feeling frustrated with bedtime temper tantrums you are likely dealing with something called Limit-Setting Sleep Disorder. This sleep disorder is common beginning around 2-3 years of age when children typically transition from a crib to a bed. Children engage in bedtime stalling techniques which include any behavior that attempts to delay bedtime. This is typically followed by a response from parents characterized by inadequate enforcement of bedtime limits, sporadic enforcement of limits, or very few or no limits set for a child. An additional good hint that this may be the problem for you and your child is if the child goes to bed and falls asleep quickly for other family members. Bedtime resistance is found in 10% to 30% of toddlers and preschoolers and approximately 15 % of children ages 4 to 10 years.
What to expect when you arrive at the sleep clinic
Fortunately, even the most extreme cases of bedtime resistance can be addressed with behavioral techniques that can lead to improvement in a few weeks with consistent follow through. When you arrive for your initial consultation with the sleep team, the team will spend time evaluating your child’s medical history, developmental history, family history (including medical history, psychological history, parenting skills, and limit-setting abilities), and your child’s behavioral history. A detailed history of your child’s sleep behaviors will also be discussed. Your child will also likely have a brief physical examination.
Treatment
Treatment for limit-setting sleep disorders includes the development of good sleep habits including establishing a set bedtime, a consistent sleep/wake schedule, and a consistent bedtime routine. Daytime habits including napping, types of physical activities, and foods consumed will be reviewed to ensure your child is developing good sleep hygiene practices. Our sleep psychologist will work with your family one-on-one to develop a personally tailored sleep behavior medicine program to fit your family’s needs. This intervention may include multiple behavioral strategies including the use of positive reinforcement, consistent parental response, clear limit-setting, the development of independent sleep skills, graduated extinction, bedtime fading, the door closing procedure, and the bedtime-passcard. Following the initial consultation and treatment session, your family will be asked to complete a 2-week sleep log so that our providers will have detailed information about how the changes you are making are working. The frequency and duration of follow-up depends on each families needs, but you can expect to return in approximately 2 weeks following your initial visit.

 
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