Journal of Child and Family Studies

, Volume 25, Issue 11, pp 3270–3277 | Cite as

Sleep-Related Outcomes Following Early Intervention for Childhood Anxiety

  • Michelle A. ClementiEmail author
  • Candice A. Alfano
  • Lindsay E. Holly
  • Armando A. Pina
Original Paper


A bidirectional relationship between sleep and anxiety is well-established whereby difficulties in one domain predict problems in the other. Interventions for childhood sleep-related problems also share considerable overlap with interventions for anxiety. Although anxious youth report high rates of sleep-related problems, it is relatively unknown whether anxiety-focused interventions for children produce improvements in sleep-related problems. The current study included N = 25 youth ages 7–16 (13 female; mean age 9.92 years ± 2.6) who participated in an early intervention program for anxiety as part of the Arizona Anxiety Resilience Building Project. Child and parent measures of sleep and anxiety symptoms were examined before and after the 12-week cognitive-behavioral intervention program. Statistically significant decreases in total sleep-related problems, bedtime resistance, sleep anxiety, and pre-sleep arousal were observed at post-intervention, though clinically meaningful change was apparent in only a small portion of the sample. Results suggest that purely anxiety-focused interventions may be useful for reducing certain types of sleep-related problems in anxious children, specifically those that occur during the bedtime/pre-sleep period. However, a lack of clinically meaningful change, in addition to post-intervention sleep-related problem scores above the clinical cut-off in a large proportion of the sample, suggest that the sleep-related problems of anxious youth may require direct attention as part of treatment.


Children Sleep Anxiety Cognitive-behavioral therapy Intervention 



This study was supported in part by Award Numbers K01MH086687 and L60MD001839 from the National Institute of Mental Health and the National Center on Minority Health and Health Disparities, as well as funding from the Institute for Mental Health Research awarded to A. Pina. Partial support also came from a prevention science fellowship awarded to L. Holly, T32 MH018387 27 from the National Institute of Mental Health.

Compliance with Ethical Standards

Conflict of interest

The authors declare that they have no conflicts of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.


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Copyright information

© Springer Science+Business Media New York 2016

Authors and Affiliations

  • Michelle A. Clementi
    • 1
    Email author
  • Candice A. Alfano
    • 1
  • Lindsay E. Holly
    • 2
  • Armando A. Pina
    • 2
  1. 1.Department of Psychology, Sleep and Anxiety Center of HoustonUniversity of HoustonHoustonUSA
  2. 2.Department of PsychologyArizona State UniversityTempeUSA

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