Counting Sheep or Losing Sleep?

Strategies for Treating Sleep Problems

by Master Trainer, Brian Sidelnick.

Sleep problems affect many types of people of all ages.

Lacking appropriate quality and quantity of sleep also affects much more than simply energy level and tiredness. Work performance, daily living, and social behavior may also become impaired by lack of sleep (Jin, Hanley & Beaulieu, 2013; McLay, Francis, Knight, Blampied & Hastie, 2019). Just as many people are affected by sleep problems, the causes, types of, and treatments for sleep problems may also vary. To effectively treat sleep problems, a number of behavioral treatment strategies may need to be incorporated into treatment that is individualized to the person.

Common Sleep Problems

Common sleep problems include sleep onset delay, frequent night wakenings, and various sleep interfering behaviors and/or inappropriate sleep dependencies (Jin et al 2013; McLay et al, 2019).

Let’s look at the first two examples. Sleep onset delay refers to the amount of time it takes to fall asleep after bedtime, and for some people, this may take up to an hour or longer to fall asleep each night. Putting it plainly, some people just can’t hit the sack when they really need to. Night wakenings are fairly self-explanatory. Some people may repeatedly wake up throughout the night and just aren’t able to get a good night’s rest.

Sleep interfering behaviors and inappropriate sleep dependencies are also sleep problems, but it may be more appropriate to consider them as either causes or symptoms of sleep problems (Jin et al, 2013; McLay et al, 2019). People with sleep problems may engage in behaviors that are incompatible with sleep, or they rely on various stimuli to fall asleep that are not (or should not appropriately) be present and available throughout the entire night. Eating or drinking at night, watching TV, or listening to music to fall asleep are a few common examples. For adults, reading or working in bed may also may affect their ability to fall asleep comfortably. For children, playing in bed or just having too many toys or activities present in or near their bed can have the same effect. Over time, these types or habits can disrupted our ability to readily fall or stay asleep.

Co-sleeping Dependency

One particularly difficult sleep dependency to overcome for children and adults is “co-sleeping”, meaning that the child needs to sleep with a parent in order to fall asleep (McLay et al, 2019). This may involve the child sleeping in the parent’s bed, or the parent sleeping in child’s room. Although there may be some occasions when this arrangement is appropriate, most people will agree that this is not an appropriate habit to develop long term. This may also be a particularly difficult habit to break.

child sleeping

Improving Sleep Problems

Fortunately, there are effective behavioral strategies for improving sleep problems. One approach to improving not just sleep problems, but also work habits and many other aspects of daily living is Situational Inducement (Martin & Pear, 2007). This behavioral approach involves rearranging the environment to improve certain daily living behaviors. This may be done by changing the time, location, or people involved with a given activity. Sometimes simply rearranging the furniture in the room can help to reduced conditioned stimuli that interferes with engaging in more effective behavior. Function-based behavioral treatments and other interventions designed to increase the motivation for sleep may also be implemented to improve sleep problems (Jin et al, 2013; McLay et al, 2019).

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Our next behavioral brief will review methods for tracking and improving sleep behavior with children. Why children? Because what better time is there to start improving sleep? Thankfully the treatment strategies reviewed may also be adapted to helping anyone.

References

Jin, C.S., Hanley, G.P., & Beaulieu, L. (2013) An Individualized and Comprehensive Approach to treat Sleep Problems in Young Children. Journal of Applied Behavior Analysis, 46 (1) Spring, 161-180.

Martin, G., & Pear, J. (2007) Behavior Modification: What it is and How To Do It. Pearson Prentice Hall, Upper Saddle River, NJ, 234-241.

McLay, L.K. France, K.G. Knight, J. Blampied, N.M. Hastie, B. (2019) The Effectiveness of Function-based Interventions to Treat Sleep Problems, Including Unwanted Co-sleeping in Children with Autism Spectrum Disorder. Behavioral Interventions, 34: 30-51.