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Abstract
Introduction Poor sleep is associated with many adverse outcomes in childhood. The most common sleep difficulty experienced by children is behavioural insomnia which responds to behavioural therapy. The Coronavirus disease 2019 (COVID-19) global pandemic in 2020 has had a profound effect on children’s sleep patterns. This project aimed to evaluate a one-to-one sleep service delivered via on-line clinics by community sleep practitioners in the UK.
Methods The study was an observational pre- and post- evaluation in a 12-month period. The intervention is derived from the behavioural aspects of Cognitive Behavioural Therapy for insomnia. The evaluation was questionnaire-based and assessed sleep parameters and wellbeing.
Results 104 parents returned completed questionnaires. Average sleep onset was 1 hour, 39 minutes pre-intervention and 20 minutes post-intervention. Average nights that the child woke per week was 3.9 pre-intervention and 0.9 post-intervention; night awakenings fell from 1.9 to 0.5 and time awake after sleep onset fell from 66. 8 minutes to 5.8 minutes. The average time slept asleep per night was 8.0 hours pre-intervention and 10.2 hours post-intervention. Improvement in all sleep measures was statistically significant (p < 0.05) see figure 1. All measures of parental and children’s wellbeing improved significantly (p < 0.05) except for their perceived ability to drive (p = 0.07), see figure 2 for children’s wellbeing scores. 100% parents stated that they would recommend the sleep support and 20% already had.
Sleep measures before and after the sleep intervention (n=104). Improvement in all measures was statistically significant (p < 0.05)
Children’s individual wellbeing measures and mean total wellbeing score before and after the sleep intervention (n=92). Each question was rated on a scale of 1-5 where 1 was good and 5 was poor. All measures showed significant improvement (p < 0.05)
Discussion We believe that this is the first report of a video-based clinic developed for children’s behavioural insomnia during the COVID-19 pandemic in the UK.
The COVID-19 pandemic has accelerated the evolution of telehealth and, in the case of children’s sleep clinics, has provided a mode of intervention delivery that is as effective as face-to-face delivery, acceptable and accessible.
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