And now another Story… – pilot study for modification of children’s sleep-related fears by reading picture books

Abstract

Background: Sleep problems in childhood are frequent. Approximately two thirds of all children and adolescents experience distressing sleep-related anxieties as they grow up. This taken by itself is indeed not a diagnosis, but it has far-reaching consequences, as the prevalence of secondary disorders such as anxiety or insomnia disorders increases. Single case studies have shown that even short bibliotherapeutic intervention programs of just a few weeks can change about changes in anxiety and problematic bedtime behavior. Picture books are an early, low-risk and cost-effective intervention of coping with sleep-related anxiety, especially for younger children, for whom sleep-related anxiety is particularly common. The aim of the study was therefore to examine the effectiveness of a low-threshold, preventive, guided and supervised bibliotherapeutic intervention with regard to sleep-related anxiety. Methods: Nineteen children aged 4.5–7 years and their parents were asked about their fears and bedtime behavior in a pre-post design with baseline and follow-up before and after reading selected picture books. Each family received an identical set of four picture books and standardized reading instructions on reading behavior. Sleep logs, parental and child assessment instruments, and interviews were used for the data collection. A two-week baseline was followed by a two-week test phase and a follow-up survey four weeks later. Results: The results show a significant improvement of sleep-related anxieties and in some problematic bedtime behavior in a pre-post comparison. The number of fears expressed, resistance to going to bed, and the frequency of waking up at night were reduced significantly. The changes remained stable four weeks after the test phase. The pilot study at hand showed positive effects of picture books on sleep-related anxieties and problematic bedtime behavior. The effects were reported from the parents and from the children. However, larger studies with control group design are necessary.