SUMMARY The outcome of 19 consecutive children referred with sleep disorders and managed by behavioural methods is described. An 84 % success rate is reported, which was maintained at 6 months' follow up. Successful outcome was associated with absence of marital discord and attendance of both parents at treatment sessions.A sleep problem is one of the most common disorders reported by parents of preschool children. Difficulty may be experienced settling a child to sleep or in frequent night waking, or both. This may seriously disrupt family life leading to fatigue, irritability, limitations on the parents' activities, and marital strain. Bax has drawn attention to the association of sleep problems with child abuse and maternal depression.'Most epidemiological studies have investigated the prevalence of night waking rather than settling problems. One study reported night waking in 23 % of infants at 1 year, 24% at 18 months, and 14% at age 3 years.2 Other studies report similar data.3-5 Richman et al.6 found that 13 % of 3 year olds were having difficulty settling to sleep and 14% were waking at night. The longitudinal studiesl 4 5 substantiate the clinical impression that in many children night waking persists through the preschool years.

In a survey of 446 children with epilepsy attending a regional EEG unit, mothers of nearly 90% of the children reported factors that appeared to act as precipitants of their children's seizures. The relationship between these factors and the seizures ranged from consistent triggers to an occasional association. There were no differences in incidence according to sex, site of focus, or type of epilepsy. Associations between environmental events or internal states are so commonly perceived by mothers that routine inquiry would appear warranted. If the event can be corroborated as a seizure precipitant, application of psychological methods of seizure control may be appropriate; if the event cannot be corroborated, needless anxiety about particular situations for a child may be avoided.

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