Sleep problems often have both medical and behavioral components, which is why the Sleep Center at CHOP features a unique interdisciplinary model that includes physicians and psychologists. From a child’s first appointment, psychosocial support is an integral part of care at the Sleep Center. Psychologists’ specialized training in behavioral sleep medicine allows a comprehensive sleep evaluation, which complements the physician assessment and exam and allows for the best treatment plan and ongoing support.

For many sleep problems, such a difficulty falling asleep or staying asleep, circadian rhythm disorders, and insomnia, research shows that the most effective treatments are behavioral interventions. Your child’s sleep psychologist will work with your family to identify what sleep habits and/or patterns you may want to change and to develop recommendations that respect the unique qualities and circumstances of each family while working toward better sleep.

Behavioral treatments are also tailored to the age and developmental level of the child. For example, parents may work on improving a toddler’s sleep by creating and sticking to a consistent bedtime and routine that enables the child to learn to fall asleep independently. On the other hand, a teenager with insomnia will work in tandem with the sleep psychologist and parents/caregivers to develop their own goals and healthy sleep habits. Changing habits or starting new habits can be hard. The sleep psychologist will also provide support for recommendations.

Medical reasons for sleep issues

For children who have a medical reason for their sleep disruption and therefore need a medical treatment, often there is a behavioral component to treatment as well.

The most common example is obstructive sleep apnea, which occurs when there are repeated events of complete or partial closing of the throat during sleep, causing your child to stop breathing briefly while sleeping. As treatment, some children will need continuous positive airway pressure (CPAP), which involves wearing a mask over the nose during sleep that is attached to a machine that blows air into the airway. This air pressure keeps the airway open and allows the child to breathe normally while sleeping. A sleep psychologist will work with you and your child to help him or her get used to the CPAP (desensitization), to help you implement it into your child’s bedtime routine, and to support you and your child in continuing to use it (adherence).

Mental health and neurodevelopmental conditions

Some mental health and neurodevelopmental conditions may interfere with sleep, and the sleep team will evaluate your child to determine the factors that are contributing to your child’s sleep problem.

If symptoms of anxiety, depression or other mental health issues are affecting your child’s sleep, they will refer your child to a mental health professional outside of the Sleep Center for treatment.

For neurodevelopmental conditions such as attention deficit/hyperactivity disorder (ADHD), autism spectrum disorders (ASDs) and trisomy 21, the sleep psychologist and sleep physician will work with your family to provide behavioral and medical recommendations as appropriate. They will often work in partnership with your developmental/behavioral pediatrician or psychiatrist to determine the best behavioral and medical interventions to address your child’s sleep problem.

Our individualized approach

Our sleep psychologists do not use “one size fits all” interventions. Because we consider the uniqueness of each child and family, the types of behavioral treatment will be specifically tailored to fit each child and family’s circumstances and goals. There are typically multiple ways to help children and families reach the same outcome: a restful night’s sleep.