Challenges and suggestions for the assessment and treatment of bedtime problems and night wakings in children under six
- 30.10.2025
- Review Article
Erschienen in:
- Verfasst von
- Guang-Hai Wang
- Yu-Jiao Deng
- Meng-Fei Zhou
- Fan Jiang
- Erschienen in
- World Journal of Pediatrics | Ausgabe 11/2025
Abstract
Background
Bedtime problems and night wakings are common in children under six, particularly in China. The current study summarizes the core tenets of the “Chinese guideline for the treatment of bedtime problems and night wakings in children under 6 years of age (2023)”, and discusses the associated challenges and suggestions for practices relevant to both domestic and international contexts.
Data sources
This review draws on literature from PubMed and Web of Science, published up to 2025, combined with evidence from the guide itself, as well as relevant consensus statements and expert recommendations.
Results
The guideline provides three strong recommendations, including behavioral intervention, early sleep hygiene education, and bedtime massage; four conditional recommendations under professional supervision, including separate sleeping arrangements, white noise, melatonin and iron supplementation; and three non-recommended interventions, including pacifier use, early complementary feeding, and daytime physical activity. Challenges in assessment and treatment involve the absence of standardized diagnostic criteria, reliance on subjective reports, multifactorial etiology with frequent comorbidities, and culturally embedded family sleep practices. Comprehensive evaluation requires integrating both subjective and objective measures while accounting for medical, behavioral, and environmental factors within cultural frameworks. Intervention should be individualized through shared decision-making with parents, combining modalities based on etiological profiling, with non-pharmacological strategies constituting first-line management.
Conclusions
Effective management for bedtime problems and night wakings in young children requires standardized tools, and culturally adaptable, and family-centered interventions according to evidence-based guidelines. Strengthening professional training and parental education is crucial for guideline implementation and improved pediatric sleep health.
Graphical abstract
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- Titel
- Challenges and suggestions for the assessment and treatment of bedtime problems and night wakings in children under six
- Verfasst von
-
Guang-Hai Wang
Yu-Jiao Deng
Meng-Fei Zhou
Fan Jiang
- Publikationsdatum
- 30.10.2025
- Verlag
- Springer Nature Singapore
- Erschienen in
-
World Journal of Pediatrics / Ausgabe 11/2025
Print ISSN: 1708-8569
Elektronische ISSN: 1867-0687 - DOI
- https://doi.org/10.1007/s12519-025-00985-5
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