Systematic Review and Meta-Analysis of Behavioral Interventions for Pediatric Insomnia

• Published in: Journal of pediatric psychology Vol. 39; no. 8; pp. 932 - 948
• Main Authors: Meltzer, Lisa J., Mindell, Jodi A.
• Format: Journal Article
• Language: English
• Published: United States 01.09.2014
• Subjects: Adolescent; Behavior Therapy - methods; Child; Female; Humans; Male; Sleep Initiation and Maintenance Disorders - psychology; Sleep Initiation and Maintenance Disorders - therapy; Treatment Outcome; treatment; night wakings; pediatric insomnia; behavioral insomnia of childhood; behavioral treatment; bedtime problems; insomnia
• ISSN: 0146-8693; 1465-735X; 1465-735X
• DOI: 10.1093/jpepsy/jsu041

To evaluate and quantify the evidence for behavioral interventions for pediatric insomnia. Meta-analysis of 16 controlled trials and qualitative analysis of 12 within-subject studies were conducted (total n = 2,560). Meta-analysis found significant effects for four specified sleep outcomes: sleep-onset latency, number of night wakings, and duration of night wakings, and sleep efficiency, with small to large effect sizes across the controlled clinical trials involving typical children. No significant effects were found for the two studies conducted with special needs populations. Finally, within-subjects studies demonstrated significant effects for all sleep outcomes with large effect sizes. Risk of bias assessment and GRADE ratings of the quality of the evidence are described. Moderate-level evidence supports behavioral interventions for pediatric insomnia in young children. However, low evidence for children, adolescents, and those with special needs (due to a lack of studies that met inclusion criteria) highlights the need for future research.