An Open Trial of Bedtime Fading for Sleep Disturbances in Preschool Children: A parent group education approach

Publication date: Available online 23 March 2018
Source:Sleep Medicine
Author(s): Michele R. Finlay, Michelle A. Short, Michael Gradisar
Study ObjectivesTo evaluate the efficacy of bedtime fading to reduce sleep disturbances in preschool aged children, using a group parent education format.DesignA repeated-measures design (pre-treatment, treatment, post-treatment and 2-year follow-up).SettingFlinders University Child & Adolescent Sleep Clinic, Adelaide, South Australia.ParticipantsParticipants were 21 children (mean age=3.0±0.80 years, range=1.5-4.0 yrs; 60% girls) identified as having difficulty initiating sleep, night waking, or a combination of both, and their mothers (M age=36.1±4.2 years).InterventionsMothers attended two group sessions which included basic sleep education (sleep needs, sleep architecture, sleep homeostasis) and bedtime fading instruction.Measurements and ResultsPrimary outcome variables were sleep onset latency (SOL), wake after sleep onset (WASO), and bedtime tantrums, measured using 2-week maternal report sleep diaries. Immediate improvements were observed over pre-treatment to treatment in average SOL per night (M=23.2±11.3min vs M=13.0±7.3min, d=0.91), average WASO per night (M=32.4±23.1min vs. M=24.0±18.3min, d=0.41), and number of bedtime tantrums per week (M=1.7±3.0 vs. M=0.4±0.7, d=0.43). Treatment gains were maintained at 2-year follow-up. Mothers rated bedtime fading highly in terms of usefulness and satisfaction, and could successfully re-implement treatment when needed.ConclusionsBedtime fading is a brief and promising intervention for pre-schoolers' sleep difficulties. This simple intervention can be easily implemented by parents in the home with little instruction, resulting in improvements to sleep and bedtime tantrums.



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