Using sleep to enhance exposure treatment for anxious children: A pilot study.

Abstract

Objectives: Exposure therapy is a well-established treatment for anxiety disorders in children; however, many young people do not fully respond to treatment. Advances in strategies to enhance extinction learning from exposure therapy are urgently needed. Emerging adult research suggests that sleep could be used to augment exposure therapy outcomes. To the best of our knowledge, the current study is the first published pilot evaluation of the potential benefits of sleep to enhance extinction learning in anxious children.

Methods: Eighteen children aged 7-12 years (M = 9.11; 38.9% Male) with a primary diagnosis of an anxiety disorder were randomized to either a period of sleep immediately following a single session of exposure (SLEEP group), or a day of wakefulness following exposure (WAKE group).

Results: Both groups improved on clinician-rated anxiety severity and children's danger severity expectancies from pre-treatment to post-treatment and 1-week follow-up. Child- and parent-rated target symptom fear ratings also improved from pre-treatment to 1-week follow-up. However, there was no evidence that children in the SLEEP group improved significantly more than the WAKE group.

Conclusions: The current pilot study failed to demonstrate an augmentation effect of post-exposure sleep in children. Practical and methodological challenges are reported for consideration in future investigations.