To cry or not to cry : the need for increased choice in behavioural sleep interventions for parents of infants

Sleep problems that do not have a physiological aetiology, but rather a behavioural or psychological aetiology, are reported in between 20% - 40% of young children and can be significant and consequential for both child and parent(s). These sleep disorders are categorised as Behavioural Insomnia of Childhood (BIC). BIC is subdivided into Sleep Association Type (where infants and young children need assistance to initiate or reinitiate sleep) or Limit Setting Type (where parents have difficulty in setting bedtime rules). Efforts to improve overnight sleep are based on principles of classical conditioning and include “cry-it-out” techniques (parents leave a child to cry themselves to sleep unattended), cue based techniques (parents respond to their child usually resulting in less with less crying) and co-sleeping (with little or no crying). The choice of which sleep intervention parents use and therefore how much crying ensues, depends on parenting style and mental health, parent and child temperament, accessibility to sleep intervention choices and sleep knowledge. This paper summarises behavioural sleep interventions, discusses their efficacy, uptake and popularity in parent communities, based on recent Australian data. Psychologists who work with children need an understanding of psychologically based sleep interventions to assist struggling families.