de Vries A, Pillen S
Centrum voor Slaapgeneeskunde, Kempenhaeghe, Heeze.
Contact: S. Pillen (
Ned Tijdschr Geneeskd. 2020 Mar 12;164:D4693.
Behavioural interventions, such as developing positive sleep-related associations and gradual extinction, are common and proven methods to treat behavioural childhood sleep problems. Although behavioural interventions are safe and effective, controversy has arisen because of the impression that they are incompatible with sensitive parenting (i.e. cued care). The practice of extinction, however, does not preclude a sensitive parenting style. It stimulates autonomy and self-regulation in the child. Instead of counterposing behavioural interventions and cued care, we suggest it is more productive to start from their similarities, such as optimizing sleep hygiene and developing a fixed sleep-wake rhythm. Such measures could be the first steps in a stepped-care model that may be supplemented with additional treatment aimed at the underlying causes of insomnia. For this comprehensive approach it is necessary to have a diverse array of evidence-based treatment options that suits the needs of both children and parents.
行为干预，如建立与睡眠相关的积极联想和逐渐消退法，是治疗儿童行为性睡眠问题的常见且经证实有效的方法。尽管行为干预安全有效，但由于有人认为它们与敏感育儿方式（即适时护理）不相容，争议由此产生。然而，消退法的实施并不排除敏感育儿方式。它能激发孩子的自主性和自我调节能力。与其将行为干预和适时护理对立起来，我们建议从它们的相似之处入手会更有成效，比如优化睡眠卫生和建立固定的睡眠 - 觉醒节律。这些措施可以是分级护理模式的第一步，该模式可能会辅以针对失眠潜在原因的额外治疗。对于这种综合方法，有必要拥有一系列符合儿童和家长需求的循证治疗方案。
