Children’s sleep problems: What can I do?

Many parents may assume that disrupted sleep is inevitable and that there is
nothing that can be done about it; but parents must be reassured that sleep
disruption is preventable and aworthwhile goal on account of all the consequences
of insufficient sleep.
Parents themselves need adequate time for sleep and rest at night and so
should realise that they need to look after themselves as well as their child as
there can be a tendency to concentrate so much on their child’s problems that
they don’t adequately take care of themselves. Parents have to realise that when
they start to undertake the above changes, there will be a temporary increase in
stress as they introduce a more consistent night-time structure. But this will be
seen to be worth it as a decrease in stress and an increase in normal sleep start
to occur.
Compliance
Skin conditions such as eczema, psoriasis, acne and vitiligo often require treatment
and medication to improve the condition. Medical compliance (how well patients
follow treatment programmes) has been a topic of study in child medicine because
compliancewith treatment programmes is very often not achieved.Although com-
pliance varies greatly by medical condition, compliance with long-term treatment
programmes is usually inferior to that of short-term treatment regimes. Typical
problems involved with the treatment of child skin disease include:
l Using topical treatments inconsistently.
l Stopping treatments when the severity of the problem diminishes.
l Failing to monitor the skin condition and hence failing to notice early signs
of recurrence/restarting treatment.
Compliance with treatments typically vary with the child’s developmental
level. For the infant and young child, the parent/caregiver takes responsibility for
the treatment. One of the problems for parents who have to administer treatment
to young children is actually getting the infant to cooperate with time-consuming
and uncomfortable tasks. Older children and adolescents tend to take a role in
their own medical care and the success with which they maintain their treatment
regime often depends upon how independent the child is.
Inthe questionofhowchildrenadhere totreatment programmes, it is important
to realise that children may be providing their parents and medical staff with false
information. Another problem occurs when parents try to present themselves as
more compliant than they actually are.
Several strategies exist to improve the compliance of children with medi-
cal regimes.
The administration of a treatment programme and any problems associated
with this should be treated as a problem to be solved. Parents should increase
both their own and their child’s knowledge about the treatment and its purpose.
Heffer and colleagues (1997) found that providing written instructions in addition
to spoken ones during child visits improved accurate recall of the treatment regime
in both parents and children. Arranging (when possible) the time of treatment
application to be thatwhich ismost suitable to the patientwill increase compliance.

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