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Sleep disorders of early childhood: a review.

Night awakening and refusal to go to sleep are common problems during the first three years of life, comprising 6-30% of children in the general population. The organization and regulation of child sleep is thought to be closely related to his mode of attachment to his mother. Sleep aids (pacifier, teddy bear, etc.) during the night seem to reduce the occurrence of sleep disorders whereas prolonged breastfeeding and co-sleep with the parents interfere with the normal development of sleep. During the preschool years, the main issue affecting sleep is the ability of parents to set firm limits while respecting the sense of autonomy of the child. Sleep disorders are considered to be more common among physically and mentally handicapped children. Children with a difficult temperament sleep less than those with an easy one. A clear association is found between sleep patterns and psychopathology of the mother probably due to emotional unavailability and inappropriate behavior. Evaluation of the disorder should follow medical examination. It should take place in the presence of the child in order to view the real interaction as well as given information about the reported interaction between the child and his mother. Therapeutic interventions in cases of early childhood sleep disorders can be behavioral or psychodynamic and are advised to be focused and brief, unless there is psychopathology in the parents.