The 4C model of healthy sleep for childhood interpersonal trauma

Restorative sleep is foundational for growth and development but remains a largely neglected area of health in the context of childhood trauma. This healthcare gap is especially great among child victims of interpersonal trauma who experience sleep disturbances at high rates. A trauma-informed framework is imperative both for understanding and addressing sleep-wake dysregulation in this vulnerable population. This article introduces the 4C Model of Healthy Sleep for Childhood Interpersonal Trauma as a resource and tool for professionals who provide services and support for these children in various settings (e.g., pediatricians, social workers, prevention specialists). Model components were developed and derived from evidence-based pediatric sleep practices, principles of attachment theory, reciprocal relationships between trauma and sleep disruption, and sleep intervention research among children with a history of foster care placement. Developed for use with infants and children up to 10 years of age, the trauma-informed model aims to educate and empower caregivers with behavioral tools for reducing sleep-related problems among child victims of interpersonal trauma including attachment disruptions. Although not intended to address complex sleep problems and disorders, the relevance and conciseness of the 4C model provides a needed resource for both research and practice.