Graduated extinction and bedtime fading significantly reduced nocturnal wakefulness in infants and maternal stress, according to Michael Gradisar, Ph.D., of Flinders University, Adelaide, South Australia, and his associates.

For the study, a group of 43 infants aged 6-16 months received either graduated extinction, bedtime fading, or sleep education. Compared with the control group of sleep education, sleep latency was significantly decreased in both the graduated extinction and bedtime fading groups. A significant reduction in number of awakenings and wake after sleep onset was seen in the graduated extinction group.

Maternal stress decreased over time in all groups, however, compared with the control group; stress was moderately reduced in the graduated extinction group and was significantly reduced in the bedtime fading group. After 12 months, no significant difference in parent-child attachment was seen between the control and noncontrol groups.

“Our data suggest introducing bedtime fading will provide quick results for improving sleep-onset latency. Graduated extinction may then be introduced to reduce nocturnal wakefulness during the night (if needed). Our data suggest sleep education alone may not be enough to help most families with an infant who has a sleep problem,” the investigators noted.

Find the full study in Pediatrics (doi: 10.1542/peds.2015-1486 ).


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