Unmasking Behavioral Issues in Young Children – The Real Issue May be Sleep Problems


Do not let behavioral and emotional issues in toddlers and preschoolers mask the real issue of sleep problems, highlights a new study published in the journal Child Psychiatry & Human Development


Conducted by John Boekamp, Clinical Director of the Pediatric Partial Hospital Program (PPHP) at Bradley Hospital in Providence, R.I. and his team, the research deals with sleep and sleep problems in young children with behavior issues.


Boekamp believes early sleep problems may be both a cause and consequence of children’s difficulties. The study examined the nature and prevalence of diagnostically defined sleep disorders, including Sleep Onset Insomnia (SOI) and Night Waking Insomnia (NWI), in a group of 183 young children admitted to the program. Overall, a high 41 percent of the children in the study met the diagnostic criteria for a sleep disorder. The findings showed that sleep problems were especially common in children with disruptive behavior, attention, anxiety, and mood problems.


Sleep difficulties are often unrecognized and under-diagnosed in children with behavioral and emotional issues, says Boekamp. Very often they may be caught in a cycle where sleep disruption affect their psychiatric symptoms and psychiatric symptoms affect their sleep-wake cycles.


Referred to as behavioral insomnias of childhood, the most common sleep difficulties reported nationally for toddlers and preschoolers are problems going to bed, falling asleep, and frequent night awakenings. Inadequate sleep leads to daytime sleepiness, less optimal preschool adjustment, and problems of irritability, hyperactivity, aggression, moodiness and low attention – symptoms of children’s difficulties with emotional self-regulation.


It is therefore critical for health providers working with young children and their families to ask about children’s sleep. “Simple questions about children’s sleep patterns, including how long it takes a child to fall asleep at night and how frequently a child awakens after falling asleep, may yield important information that is relevant to clinical care, even when sleep problems are not the primary focus of treatment,” says Boekamp


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