In children, insomnia typically is not a primary condition, but rather associated with psychological or medical conditions, such as anxiety, depression, pain, asthma and cystic fibrosis. Daytime somnolence associated with insomnia in childhood and adolescence may cause impairment in attention, cognition and memory, which can adversely impact academic performance. Insomnia is defined as difficulty in falling asleep, prolonged nighttime awakenings, or insufficient amount or quality of sleep, which affects daytime functioning, despite adequate opportunity for sleep. Use of hypnosis appears to facilitate efficient therapy for insomnia in school-age children. Among these patients, 87% reported improvement or resolution of the somatic complaints following hypnosis. Somatic complaints amenable to hypnosis were reported by 41%, including chest pain, dyspnea, functional abdominal pain, habit cough, headaches, and vocal cord dysfunction. Of the 21 patients reporting nighttime awakenings more than once a week, 52% reported resolution of the awakenings and 38% reported improvement. Of the 70 patients reporting a delay in sleep onset of more than 30 minutes, 90% reported a reduction in sleep onset time following hypnosis. Two or fewer hypnosis sessions were provided to 68% of the patients. Younger children were more likely to report that the insomnia was related to fears. When insomnia did not resolve after the first instruction session, patients were offered the opportunity to use hypnosis to gain insight into the cause. Their mean age was 12 years (range, 7–17). Seventy-five patients returned for follow-up after the first hypnosis session. All patients were offered and accepted instruction in self-hypnosis for treatment of insomnia, and for other symptoms if it was felt that these were amenable to therapy with hypnosis. MethodsĪ retrospective chart review was performed for 84 children and adolescents with insomnia, excluding those with central or obstructive sleep apnea.
The purposes of this study are to document psychosocial stressors and medical conditions associated with development of insomnia in school-age children and to report use of hypnosis for this condition.
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