Remote treatment of sleep‐related trichotillomania and trichophagia

Lichtblau et al. (2018) worked with one child who pulled her hair and ate it only at bedtime.

The team coached the parents over Zoom. They added a low dose of melatonin and set the same bed and wake time every day.

Parents recorded head and mouth touches each night with a simple tally sheet.

Hair pulling and eating dropped to zero within a few weeks.

The child also fell asleep faster and stayed asleep longer.

Parents said the remote plan was easy to follow at home.

Koudys et al. (2025) later used the same remote-coach model with motion cameras and an app. They helped three autistic kids stop co-sleeping and hit age-typical sleep lengths. The tech upgrade shows the idea keeps working when you add gadgets.

Tilford et al. (2015) tested melatonin plus bedtime rules in person for kids with autism. Child sleep and parent mood both improved. The new case proves you can get similar gains without driving to clinic.

Paone et al. (2026) surveyed families and found sleep drivers change with age. That warns us to check why the child wakes before we pick melatonin or any single fix.

You can now treat sleep-linked problem behavior without office visits. Start with a stable bedtime, low-dose melatonin, and nightly parent data. If the behavior is tied to sleep, you may see quick change and happier families.