Assessment of brief interventions for nighttime fears in preschool children

Eur J Pediatr. 2012 Jan;171(1):67-75. doi: 10.1007/s00431-011-1488-4. Epub 2011 May 19.


Nighttime fears (NF) and sleep problems continue to be major problems in clinical services. The aim was to assess the effects of two brief interventions on NF, and related sleep problems and parental fear-reducing behaviors in children. One hundred and four children aged 4-6 years with significant NF were randomly assigned into two intervention groups: the Huggy-Puppy intervention (HPI), which is based on providing children a puppy doll with a request to take care of the doll, and a revised version (HPI-r) which is based on providing the same doll with a cover story that the doll will serve as a protector. At baseline, the domains of NF, behavior problems, and sleep disruptions were assessed. Data were collected from parents and children using objective and subjective measures. The effects of the interventions were assessed by comparing four time points: baseline, first week of intervention, 1 month, and 6 months after initial intervention time. A waiting list comparison group (WL) was used as spontaneous recovery comparison group. Both interventions significantly reduced NF with similar impact. The improvement after 1 month was significantly higher than in the WL group. Furthermore, both interventions significantly reduced parental fear management behaviors and children's sleep problems. Finally, the reduction in NF and parental fear management strategies were maintained 6 months post-treatment.

Conclusions: Relatively simple and cost-effective doll interventions can reduce NF and their associated sleep problems. Further research is needed to implement these interventions for other anxiety disorders in childhood.

Publication types

  • Comparative Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Actigraphy
  • Child
  • Child, Preschool
  • Cognitive Behavioral Therapy / methods*
  • Fear*
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Maternal Behavior
  • Object Attachment
  • Parent-Child Relations
  • Paternal Behavior
  • Play and Playthings
  • Sleep Wake Disorders / etiology
  • Sleep Wake Disorders / psychology
  • Sleep Wake Disorders / therapy*
  • Surveys and Questionnaires
  • Treatment Outcome