patients with difficulty sleeping, defined as taking at least 30 minutes
to settle or waking during the night requiring parental contact to fall
back to sleep, were randomized in a single-blinded, controlled trial
to attempt either total ignoring of all crying, graduated ignoring of
crying, or a “waitlist” condition in which the parents continued methods
they had previously attempted without success.
Waitlist and treatment groups had similar characteristics at the onset.
Primary outcome measures after one, two, three, and six weeks included
number of “good bedtimes,” or nights that took less than ten minutes
for the child to settle; and “good nighttimes,” or nights in which the
child slept by himself without waking for the whole night.
Secondary outcomes were maternal stress, parent-child dysfunctional
interactions, child behavior, maternal depression, and parent distress.
Analysis was not on an intention to treat basis.
Because of lack of intention to treat analysis, the subpopulation studied
actually contained only parents who were willing to allow their children
to cry themselves to sleep.
In this subpopulation, there was a valid, moderate-to-large effect,
on both the number of good bedtimes per week and the number of good
nights per week.
There were no adverse effects on any secondary outcomes in the subpopulation