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Disturbances of sleep are the first reliable signs of emotional conflict in children, preceding any other overt indication in behaviour. Each phase of development has its own pattern. If the small infant's natural ability to sleep is disturbed, external interference should be suspected. In the second and third years, mild disturbances are common. They are associated with the repression of anal-erotic and aggressive drives. Additional traumata (such as the birth of a sibling, which often induces a mother to speed toilet training) are immediately reflected in them. Particularly important are emotional over-stimulation and seduction, because they prematurely stimulate phallic impulses and thus reinforce anal conflicts and intensify the child's repressive struggles. In the oedipal phase disturbances are also ordinarily mild and temporary. They are typified by occasional nightmares and difficulty in falling asleep. When they are more severe the traumatic agent is the excessive suppression by the parents of the child's sexual interests and jealousy, frequently combined with over-stimulation. Acute suppression of object-directed destructive impulses leads to the formation of a 'sleep-phobia'.
The psychodynamics of neurotic sleep disturbances in children are similar to those of traumatic neuroses. Though chronic insomnia is always serious, treatment is not too difficult if initiated promptly.