Piazza C C, Fisher W
Johns Hopkins University School of Medicine, Baltimore, Maryland.
J Appl Behav Anal. 1991 Spring;24(1):129-40. doi: 10.1901/jaba.1991.24-129.
The sleep-wake cycles of 4 developmentally delayed individuals with longstanding severe sleep disturbances were regulated using a faded bedtime procedure with response cost. Bedtimes were systematically delayed for each individual, thus increasing the probability of short latency to sleep onset. The response cost component, consisting of removing the individual from bed for 1 hour, was implemented when an individual did not experience short latency to sleep onset. A fading procedure was then applied successfully to advance the bedtimes and to gradually increase durations of sleep. Specifically, all 4 individuals had decreased amounts of nighttime sleep that increased following treatment. Two of the 4 individuals showed excessive daytime sleep that decreased following treatment. Three of the 4 individuals experienced decreases in night wakings following treatment. Both environmental and biological manipulations of the sleep-wake cycle are hypothesized as mechanisms of treatment. The relative advantages of this procedure over other procedures for the treatment of pediatric sleep disorders are discussed, as are directions for future research.
采用带有反应代价的渐退就寝程序，对4名患有长期严重睡眠障碍的发育迟缓个体的睡眠-觉醒周期进行调节。为每个个体系统地推迟就寝时间，从而增加入睡潜伏期短的可能性。当个体未经历短入睡潜伏期时，实施反应代价部分，即让个体离开床1小时。然后成功应用渐退程序来提前就寝时间并逐渐增加睡眠时间。具体而言，所有4名个体夜间睡眠量减少，治疗后增加。4名个体中有2名表现出白天过度嗜睡，治疗后减少。4名个体中有3名治疗后夜间觉醒次数减少。睡眠-觉醒周期的环境和生物调节均被假设为治疗机制。讨论了该程序相对于其他治疗小儿睡眠障碍程序的相对优势，以及未来研究的方向。
