What is a "behavioral" sleep problem or disorder?

What is a "behavioral" sleep problem or disorder?

Gary Feldman (Medical Director, Stramski Disorders Center, Miller Children's Hospital ) gives expert video advice on: What are the most common sleep problems for teenagers? and more...

A behavorial sleep problem is probably the most common sleep problem that children have. Only about three to five percent of children have problems with breathing at night. 75% of sleep problems that kids have are behavioral. Now, it's all got to do with habit and routine, and sleep-onset associations. A child that has “bad” sleep-onset associations will wake up in the middle of the night and require those associations again, and that obviously is a problem. Now, when we talk about behavioral problems in children, the technical term is “behavioral insomnia of childhood.” Insomnia meaning “unable to fall asleep,” and it's behavior-related, and it's related to kids. We break those down into three different subtypes. We have the behavioral insomnia of childhood-sleep onset association type. Now, that would be the child that's used to being nursed, and the music, and the TV, and being rocked, and held, and whatever – the whole list of things in order to help them fall asleep. Then, you have the limit-setting type. That's usually with the older child, that says, “I don't want to go to sleep.” Or they get put into bed, and say “I need a drink of water. Oh, can Mummy give me one more kiss? I need the light on. Etc etc. Making all these excuses to not go to sleep. That would be limit-setting type. Then, the third category is just both of them smushed together as what we call combined type, because it can happen like that. These are all behavioral. The way to deal with them is to change the behavior, and changing the behavior is really changing habit.