Effectiveness of The KiSS Cognitive-Behavior Multicomponent Therapy on Insomnia and Fatigue in Children

Document Type : Research Paper

Authors

1 Ph.D Student of Psychology and Education of Exceptional Children, Department of General and Exceptional Psychology, Central Tehran Branch, Islamic Azad University, Tehran, Iran.

2 Assistant Professor, Department of General and Exceptional Psychology, Central Tehran Branch, Islamic Azad University, Tehran, Iran. (Corresponding author)

3 Associate Professor, Department of Psychiatry, Faculty of Behavioral Sciences, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.

Abstract

Introduction: Insomnia is one of the most common sleep disorders in children. this study aimed to evaluate the effectiveness of cognitive-behavior multicomponent Therapy, named the KiSS program (Kinder mit Schafstörungen Programm) on insomnia and fatigue in children.
Methods: This research method was quasi-experimental with a pre-test -post-test, and follow-up design in experimental and control groups. In order to perform this study among children of 8 to 10 years with insomnia referring to Medical & Psychology Clinic of Shokoufeh in, Tehran, Iran, within July to October 2021, 40 children were selected by the convenience sampling method based on inclusion criteria and were assigned randomly into experimental and control groups (each group including 20 children).The personal information questionnaire, Sleep Disturbance Scale for children (SDSC), Multidimensional Fatigue Scale (MFS) and Child Symptoms Inventory-4 (CSI-4) were used to collect data. The KiSS treatment was applied in the experimental group and cartoon watching in the control group. Due to the decrease in the number of subjects in the implementation phase, the number of children in each group was reduced to 15. The data were analyzed with SPSS software (version 22) using descriptive statistical indicators including mean and standard deviation and inferential statistics indicators including mixed-design ANOVA method.
Conclusion: Considering to the promising results of KiSS multicomponent therapy, this treatment can be used as one of the intervention methods for improvement of insomnia and fatigue caused by it in children aged 8 to 10 years.

Keywords


  1. Sheldon S, Ferber R, Kryger M, Gozal D. Principles and Practice of Pediatric Sleep Medicine. 2nd ed ed. USA Elsevier 2014.
  2. Fadzil A. Factors affecting the quality of sleep in children. Children. 2021;8(2):122.
  3. Nevšímalová S, Bruni O. Sleep disorders in children. Springer; 2016.
  4. Donskoy I, Loghmanee D. Insomnia in adolescence. Medical Sciences. 2018;6(3):72.
  5. Ma ZR, Shi LJ, Deng MH. Efficacy of cognitive behavioral therapy in children and adolescents with insomnia: a systematic review and meta-analysis. Braz J Med Biol Res. 2018;51(6):e7070. doi:10.1590/1414-431x20187070. [PubMed:29791593].
  6. Sadock BJ, Sadock VA, Ruiz P. Kaplan and Sadocks comprehensive textbook of psychiatry 10nd ed ed. Philadelphia: : Wolters Kluwer; 2017.
  7. Carter JC, Wrede JE. Overview of Sleep and Sleep Disorders in Infancy and Childhood. Pediatr Ann. 2017;46(4):e133-e8. doi:10.3928/19382359-20170316-02. [PubMed:28414394].
  8. 8. Tsai SC, Lee-Chiong T. Sleep disorders and fatigue. Sleep Medicine Clinics. 2013;8(2):235-9.
  9. Morin CM. Insomnia: Psychological assessment and management. Guilford press; 1996.

10.Schlarb AA. Kiss- Therapeuten manual: Das training fur kinder von 5 bis 10 jahren mit schalfstorungen (Kiss treatment manual: treatment for children aged 5 to 10 years with sleep disorders.). Stuttgart, Germany: Kohlhammer verlag 2013.

  1. Liu J, Zhou G, Wang Y, Ai Y, Pinto-Martin J, Liu X. Sleep problems, fatigue, and cognitive performance in Chinese kindergarten children. The Journal of pediatrics. 2012;161(3):520-5. e2.
  2. Sedky K, Nazir R, Bennett D. Sleep Medicine and Mental Health: A Guide for Psychiatrists and Other Healthcare Professionals. Springer; 2020.
  3. 13. Lewin DS. Application of cognitive behavioral therapy for insomnia in the pediatric population. Sleep Medicine Clinical 2014;9(2):169-80. doi:10.1016/j.jsmc.2014.03.003.
  4. 14. Schlarb AA, Velten-Schurian K, Poets CF, Hautzinger M. First effects of a multicomponent treatment for sleep disorders in children. Nature and Science of Sleep. 2011;3:1.
  5. 15. Schlarb AA, Bihlmaier I, Velten-Schurian K, Poets CF, Hautzinger M. Short- and Long-Term Effects of CBT-I in Groups for School-Age Children Suffering From Chronic Insomnia: The KiSS-Program. Behav Sleep Med. 2018;16(4):380-97. doi:10.1080/15402002.2016.122864.
  6. Paine S, Gradisar M. A randomised controlled trial of cognitive-behaviour therapy for behavioural insomnia of childhood in school-aged children. Behav Res Ther. 2011;49(6-7):379-88. doi:10.1016/j.brat.2011.03.008. [PubMed:21550589].
  7. 17. Clancy M, Drerup M, Sullivan AB. Outcomes of cognitive-behavioral treatment for insomnia on insomnia, depression, and fatigue for individuals with multiple sclerosis: a case series. International journal of MS care. 2015;17(6):261-7.
  8. 18. Redeker NS, Jeon S, Andrews L, Cline J, Mohsenin V, Jacoby D. Effects of cognitive behavioral therapy for insomnia on sleep-related cognitions among patients with stable heart failure. Behavioral sleep medicine. 2019;17(3):342-54.
  9. 19. Malek-Afzali H, Majdzadeh R, Fotouhi A, Tavakoli S. Methodology of applied research in medical sciences. Tehran: Tehran Medical Sciences University Publications 2004.
  10. 20. Bruni O, Ottaviano S, Guidetti V, Romoli M, Innocenzi M, Cortesi F, et al. The Sleep Disturbance Scale for Children (SDSC). Construction and validation of an instrument to evaluate sleep disturbances in childhood and adolescence. J Sleep Res. 1996;5(4):251-61. doi:10.1111/j.1365-2869.1996.00251.x. [PubMed:9065877].
  11. Blunden S, Lushington K, Lorenzen B, Ooi T, Fung F, Kennedy D. Are sleep problems under-recognised in general practice? Arch Dis Child. 2004;89(8):708-12. doi:10.1136/adc.2003.027011. [PubMed:15269066].
  12. 22. Ghaneian M, Kazemi-Zahrani H. Prevalence of sleep disturbance and neuropsychological learning disabilities in preschool children in Isfahan city. Journal Shahid Sadoughi University Medical Sciences 2016;24(6):501-12.
  13. 23. Suzanne Gordijn M, Cremers EM, Kaspers GJ, Gemke RJ. Fatigue in children: reliability and validity of the Dutch PedsQLTM Multidimensional Fatigue Scale. Quality of Life Research. 2011;20(7):1103-8.
  14. 24. Varni JW, Limbers CA. The PedsQL™ Multidimensional Fatigue Scale in young adults: feasibility, reliability and validity in a University student population. Quality of Life Research. 2014;17(1):105-114.
  15. 25. Sharma R, Stanek JR, Koch TL, Grooms L, O'Brien SH. Intravenous iron therapy in non‐anemic iron‐deficient menstruating adolescent females with fatigue. American journal of hematology. 2016;91(10):973-7.
  16. Varni JW, Burwinkle TM, Katz ER, Meeske K, Dickinson P. The PedsQL™ in pediatric cancer: reliability and validity of the pediatric quality of life inventory™ generic core scales, multidimensional fatigue scale, and cancer module. Cancer. 2002;94(7):2090-106.
  17. 27. Mohammad Esmaeel Adaptation and Standardization of Child Symptom Inventory-4 (CSI-4). Journal of Exceptional children 2007;7(1):79-96
  18. De Bruin EJ, Bogels SM, Oort FJ, Meijer AM. Efficacy of Cognitive Behavioral Therapy for Insomnia in Adolescents: A Randomized Controlled Trial with Internet Therapy, Group Therapy and A Waiting List Condition. Sleep. 2015;38(12):1913-26. doi:10.5665/sleep.5240. [PubMed:26158889].
  19. Muench A, Vargas I, Posner D, Perlis ML. Standard cognitive behavioral therapy for insomnia (CBT-I): When is the adaptation of CBT-I warranted? Adapting Cognitive Behavioral Therapy for Insomnia: Elsevier; 2022. p. 3-24.
  20. Borzou S, Khavari F, Tapak L. The effects of sleep hygiene education on fatigue and sleep quality in hemodialysis patients: A quesi experimental study. Avicenna Journal Nursing Midwifery Care. . 2019;27(1):25-34.
  21. Nguyen S, McKay A, Wong D, Rajaratnam SM, Spitz G, Williams G, et al. Cognitive behavior therapy to treat sleep disturbance and fatigue after traumatic brain injury: a pilot randomized controlled trial. Archives of physical medicine and rehabilitation. 2017;98(8):1508-17. e2.