Behaviourial Insomnia in Childhood (BIC)

Insomnia, which is the inability to initiate and/or maintain sleep, may not only affect children, but also their parents and the whole household.

There are many possible causes of insomnia in children, including behavioural insomnia of childhood (which is discussed below), delayed sleep phase disorder (common in adolescents due to a ‘shift in their body clock’ at puberty), medical conditions (causing pain, itching or coughing in the night), psychological conditions (e.g. anxiety, depression, stress) and medications.

This section will discuss behavioural insomnia of childhood, which can be further classified into sleep-onset association type, limit-setting type, or combined. If you suspect that your child has insomnia, consult a doctor who may refer your child to a paediatric sleep specialist.

Sleep Onset Association Type BIC

A child with sleep-onset association BIC relies on a specific stimulation (object or setting) for the initiation of sleep at bedtime, or to fall back to sleep following an awakening in the night.

Associations that are highly demanding or disruptive to the caregivers are considered negative sleep onset associations (e.g. prolonged rocking, night feedings inappropriate for age).

How common is it?

This is common, and estimated to affect between 25 to 50 percent of infants at the age of 6 to 12 months of age, and 15 to 20 percent of toddlers.