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Orton O, Bilgin A. Maternal Depression and Sleep Problems in Early Childhood: A Meta-Analysis. Child Psychiatry Hum Dev 2024:10.1007/s10578-024-01717-y. [PMID: 38836978 DOI: 10.1007/s10578-024-01717-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/16/2024] [Indexed: 06/06/2024]
Abstract
Both prenatal and postnatal maternal depression have been associated with increased sleep problems in early childhood. However, this association is less consistent for postnatal depression, and the strength of the association remains unclear. The aim of the current study was to provide a quantitative synthesis of the literature to estimate the magnitude of the association between maternal depression and sleep problems in early childhood. Medline, PsycINFO, PsycARTICLES, Web of Science, and Scopus were searched for prospective longitudinal studies from 1970 to December 2022. Of 117 articles screened, 22 studies met the inclusion criteria. Both prenatal depression (OR = 1.82; 95% CI = 1.28-2.61) and postnatal depression (OR = 1.65; 95% CI = 1.50-1.82) were associated with increased likelihood of sleep problems in early childhood. The heterogeneity between the studies was significant and high both for prenatal (Q = 432.323; I2 = 97.456, P < .001) and postnatal depression (Q = 44.902, I2 = 65.594, P < .001), which mean that conclusions are tentative and need to be considered within the possible influence of unmeasured confounding. However, mitigating depression symptoms in mothers both during pregnancy and in the postnatal period would be an effective strategy for reducing sleep problems in children.
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Affiliation(s)
| | - Ayten Bilgin
- Department of Psychology, University of Essex, Colchester, UK.
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2
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Carroll AJ, Appleton J, Harris KM. Child sleep problems, maternal sleep and self-efficacy: Sleep's complicated role in maternal depression. J Sleep Res 2024; 33:e14005. [PMID: 37483064 DOI: 10.1111/jsr.14005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2022] [Revised: 06/27/2023] [Accepted: 07/04/2023] [Indexed: 07/25/2023]
Abstract
Depression, poor sleep duration and low self-efficacy are common in mothers of children with sleep problems. However, research rarely extends beyond the postpartum period. This study investigated the multifaceted relationship between child sleep and maternal depression in early motherhood. A confidential survey assessed child sleep problems, maternal sleep duration, parental self-efficacy and depressive symptoms in 477 Australian mothers of children aged 3 months to 5 years. We found no relationship between child age and maternal depression, supporting our decision to look beyond postpartum depression. Robust bootstrapped mediation modelling tested the hypothesis that both maternal sleep duration and parental self-efficacy would mediate child sleep problems as predictors of maternal depression. After controlling for child age, results showed a significant parallel mediation effect, demonstrating that maternal sleep duration and parental self-efficacy both mediate the relationship between child sleep problems on maternal depression. While the total effect of child sleep problems on maternal depression was statistically significant, after partialling out the effects of other variables, child sleep problems no longer predicted maternal depression. Akaike information criterion analyses supported the full model, with both mediators explaining meaningful variance in maternal depression. This study expands our knowledge beyond the postpartum period, and divulges the disparate effects of sleep deprivation and parental self-efficacy on the relationship between child sleep and depression in early motherhood. Maternal sleep duration and self-efficacy are modifiable risk factors of maternal depression, indicating possible efficacious treatments. Parental self-efficacy stands out as a direction for clinical practice and further psychobiological study.
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Affiliation(s)
- Alyssa J Carroll
- School of Psychology, Charles Sturt University, Port Macquarie, New South Wales, Australia
| | - Jessica Appleton
- Tresillian Family Care Centres, Belmore, New South Wales, Australia
- Faculty of Health, University of Technology Sydney, Ultimo, New South Wales, Australia
| | - Keith M Harris
- School of Psychology, Charles Sturt University, Port Macquarie, New South Wales, Australia
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3
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Mathiasen S, Parsons CE, Fusaroli R, Paavonen EJ, Karlsson H, Karlsson L. Maternal depression and anxiety symptoms across pregnancy and the postnatal period: Modest associations between depression symptoms and infant sleep outcomes. Sleep Med 2023; 112:291-300. [PMID: 37950940 DOI: 10.1016/j.sleep.2023.10.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Revised: 09/29/2023] [Accepted: 10/08/2023] [Indexed: 11/13/2023]
Abstract
Maternal depression and anxiety symptoms are common across the perinatal period and are associated with a raised risk for adverse child outcomes. While substantial evidence exists for child outcomes such as behaviour, language and cognition, infant sleep has been less studied. In this longitudinal study, we examined the association between maternal symptoms of depression and anxiety and mother-reported infant sleep at 6 and 12 months. Across the four infant sleep outcomes, total sleep time, sleep onset latency, number of awakenings and a maternal perception variable, we found modest effects for concomitant depression symptoms. There were almost no additional effects for anxiety symptoms beyond that already accounted for by depression. Using trajectory modelling of maternal symptoms at five time points, we found more robust effects for maternal groups with postnatally emerging symptoms over prenatally present symptoms across all four sleep outcomes. Our strongest finding was that mothers with postnatal depression symptoms were more likely to perceive their infant's sleep as problematic compared with all other mothers. Where we found effects on duration-based infant sleep outcomes overall, these were small and clearest for depressive symptoms over anxiety symptoms. For both nighttime awakenings and perception of sleep as a problem, effects were apparent only for mothers in the postnatal symptom groups, and not for prenatal symptoms, at both infant ages six and 12 months. Our sample was a relatively high-socioeconomic group with low symptoms overall, and findings may not generalize to more vulnerable populations.
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Affiliation(s)
| | | | | | - E Juulia Paavonen
- Public Health and Welfare, National Institute for Health and Welfare, Helsinki, Finland; Pediatric Research Center, Child Psychiatry, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Hasse Karlsson
- FinnBrain Birth Cohort Study, Department of Clinical Medicine, Brain and Mind Center, University of Turku, Turku, Finland; Department of Psychiatry, University of Turku and Turku University Hospital, Turku, Finland; Centre for Population Health Research, University of Turku, Turku, Finland
| | - Linnea Karlsson
- FinnBrain Birth Cohort Study, Department of Clinical Medicine, Brain and Mind Center, University of Turku, Turku, Finland; Centre for Population Health Research, University of Turku, Turku, Finland; Department of Clinical Medicine, Paediatrics and Adolescent Medicine, Turku University Hospital and University of Turku, Finland
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Dias CC, Pinto TM, Figueiredo B. Maternal Prenatal Depressive Symptoms and Infant Sleep Problems: The Role of Infant Temperament and Sex. Behav Sleep Med 2023; 21:695-711. [PMID: 36533573 DOI: 10.1080/15402002.2022.2155162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
OBJECTIVES We aimed to analyze whether (1) infant temperament mediates the impact of maternal prenatal depressive symptoms on infant sleep problems and (2) the mediation role of infant temperament was moderated by the infant's sex. METHODS The sample was comprised of 172 mother-infant dyads. Mothers completed self-reported measures of prenatal and postnatal depressive symptoms, infant temperament (negative affectivity, surgency/extraversion, and orienting regulation), and sleep problems. RESULTS While controlling for maternal postnatal depressive symptoms, our results revealed that (1) infant negative affectivity at two weeks partially mediated the impact of maternal prenatal depressive symptoms on sleep anxiety at six months, and (2) this mediation is independent of the infant's sex. CONCLUSIONS Our findings provided evidence that negative affectivity can be an early specific marker of sleep anxiety and can partially explain the negative impact of maternal prenatal depressive symptoms on further sleep problems in the infant.
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Affiliation(s)
| | - Tiago Miguel Pinto
- School of Psychology, University of Minho, Braga, Portugal
- Lusófona University, HEI-Lab, Porto, Portugal
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D'Souza L, Cassels T. Contextual considerations in infant sleep: Offering alternative interventions to families. Sleep Health 2023; 9:618-625. [PMID: 35768320 DOI: 10.1016/j.sleh.2022.05.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Revised: 05/03/2022] [Accepted: 05/19/2022] [Indexed: 10/17/2022]
Abstract
Infant sleep problems are one of the commonly reported reasons parents seek professional help, yet what constitutes a "sleep problem" depends on the models used to explain the development of infant sleep. The current models are based on research conducted in the western context where infant solitary sleeping is the norm. Parent-child co-sleeping is the norm in many cultures around the world. We argue that the primary focus of current research on parent-child interactions as the mediating context for the development of infant sleep problems has inherently made these models and ensuing interventions less sensitive and applicable to infant sleep problems in the context of co-sleeping families. When families present for help with infant sleep difficulties, extinction based behavioral interventions or interventions focused on reducing parental presence at bedtime are commonly recommended. These recommendations may not always align with cultural values and parenting practices of all families, therefore precluding these families from getting necessary help. In attempting to provide families with choices that depart from behavioral based interventions, this paper draws on research and adapts current models to propose an alternative to conceptualize perceptions of infant sleep problems that may be sensitive to and applied across various cultural and personal contexts. We attempt to provide a rationale for interventions that are inclusive and sensitive to families where reduced parental nighttime responsiveness may not be a preferred choice.
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Affiliation(s)
- Levita D'Souza
- Faculty of Education, Monash University, 19 Ancora Imparo Way, Clayton, Victoria, 3800, Australia.
| | - Tracy Cassels
- Evolutionary Parenting, 116 County Rd, 16 Milford, ON, K0K 2P0, Canada
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Acosta J, Parent J, Hare M, DiMarzio K, Sisitsky M, McMakin DL. Development of the Nighttime Parenting Scale: Differentiating nighttime versus general parenting practices and their impact on youth sleep health. Sleep Health 2023; 9:489-496. [PMID: 37393144 DOI: 10.1016/j.sleh.2023.05.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 03/06/2023] [Accepted: 05/08/2023] [Indexed: 07/03/2023]
Abstract
OBJECTIVES The current study provides a novel method of assessing the impact of nighttime parenting practices on youth sleep health during the sensitive transition from childhood to adolescence (ie., peri-puberty). Specifically, we aimed to advance the measurement of nighttime parenting by developing a conceptually driven questionnaire for use in research and clinical settings. METHOD A total of 625 parents (67.9% mothers) of peripubertal youth (age M=11.6, SD=1.31) were recruited online and completed self-report questionnaires. The sample was primarily White (67.4%), followed by 16.5% Black, 13.1% Latinx, and 9.6% Asian. Factor structure was examined through four empirically-driven stages (ie, exploratory factor analyses, confirmatory factor analyses, examining internal and test-retest reliability, and indices of validity). Furthermore, the current study sought to validate nighttime parenting as a unique construct by exploring associations with peripubertal youth sleep health. RESULTS A factor structure consisting of six dimensions of nighttime parenting was established (ie, nighttime supportiveness, hostility, physical control, limit-setting, media monitoring, and co-sleeping behaviors). Furthermore, the current measure demonstrated strong psychometric properties. Finally, the established dimensions were cross-sectionally associated with youth sleep health indices. CONCLUSIONS This study extends previous research by examining the influence of distinct domains of parenting practices that specifically occur at nighttime and how these differentially relate to youth sleep health. Results suggest that intervention and/or prevention programs targeting sleep should place emphasis on fostering positive parenting at nighttime as a strategy for creating an evening environment that is conducive to optimizing youth sleep health.
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Affiliation(s)
- Juliana Acosta
- Center for Children and Families, Florida International University, Miami, Florida, USA; Mailman Center for Child Development, University of Miami Miller School of Medicine, Miami, Florida, USA.
| | - Justin Parent
- Center for Children and Families, Florida International University, Miami, Florida, USA; Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, Rhode Island, USA; Bradley/Hasbro Children's Research Center, E. P. Bradley Hospital, Providence, Rhode Island, USA.
| | - Megan Hare
- Center for Children and Families, Florida International University, Miami, Florida, USA
| | - Karissa DiMarzio
- Center for Children and Families, Florida International University, Miami, Florida, USA
| | - Michaela Sisitsky
- Center for Children and Families, Florida International University, Miami, Florida, USA
| | - Dana L McMakin
- Center for Children and Families, Florida International University, Miami, Florida, USA; Department of Neurology, Nicklaus Children's Hospital, Miami, Florida, USA
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Kumagai M, Shinohara H, Kodama H. Possible contribution of better maternal psychological well-being to the acquisition of sleeping through the night in infants during the early postpartum period. Infant Behav Dev 2023; 72:101872. [PMID: 37542836 DOI: 10.1016/j.infbeh.2023.101872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2022] [Revised: 07/07/2023] [Accepted: 07/31/2023] [Indexed: 08/07/2023]
Abstract
The objective of this study was to elucidate whether better maternal psychological well-being contributes to the acquisition of "sleeping through the night" (STN) in infants during the early postpartum period. Fifty-two primiparous mothers completed the General Health Questionnaire-28 (GHQ-28) in the third trimester (prenatal) and when the conceptional ages of their babies reached 8-9 weeks (hereafter, 2 months), 12-13 weeks (3 months), and 16-17 weeks (4 months). They also recorded babies' nocturnal sleep patterns in a timetable for 5 consecutive days each month postpartum. "Regular STN" was defined when the mean of longest nocturnal sleep duration for 5 consecutive days was > 8 h or between 6 and 8 h with < 1.0 nocturnal awakenings. According to these criteria, a total of 14 infants (27 %) acquired regular STN at 4 months (referred to as "STN infants"), with STN infants showing a marked increase in longest nocturnal sleep duration and a decrease in nocturnal awakenings from 2 to 3 months of age. The mothers of STN infants demonstrated steady reductions in postnatal GHQ-28 scores and had significantly lower prenatal GHQ-28 scores compared with the mothers of non-STN infants (3.7 ± 3.0 vs. 6.4 ± 4.1, p = 0.027). In random forest models for binomial classification, both prenatal and postnatal (at 4 months) GHQ-28 scores were identified as significant covariates for distinguishing STN infants, and other important covariates, including weeks of delivery, stepfamily, birth weight of the infant, and maternal co-sleeping at bedtime, were selected. Among these covariates, maternal co-sleeping at bedtime had relatively stronger correlations with both STN infants (r = - 0.440) and prenatal maternal GHQ-28 scores (r = 0.377). In conclusion, because prenatal maternal psychological well-being was thought to predict the acquisition of STN in infants, infants born from mothers with better psychological well-being appear to have some advantages in acquiring STN. These cross-lagged correlations suggest that the pathway from mothers to infants may be mediated by certain parenting behaviors, such as maternal co-sleeping at bedtime.
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Affiliation(s)
- Mayuko Kumagai
- Department of Maternity Nursing, Akita University Graduate School of Medicine and Faculty of Medicine, School of Health Science, Japan
| | | | - Hideya Kodama
- Department of Maternity Nursing, Akita University Graduate School of Medicine and Faculty of Medicine, School of Health Science, Japan.
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8
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Cai T, Sutter C, Donovan SM, Fiese BH. The Relationship Between Maternal and Infant Sleep Duration Across the First Two Years. J Dev Behav Pediatr 2023; 44:e421-e428. [PMID: 37276363 PMCID: PMC10524561 DOI: 10.1097/dbp.0000000000001195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Accepted: 04/03/2023] [Indexed: 06/07/2023]
Abstract
OBJECTIVES The first objective of this study was to determine how mother-infant sleep duration is related across the first 2 years of life. The second objective was to determine whether these relationships change across the first 2 years of life. The third objective was to understand demographic and health predictors of the relationship between maternal and child sleep. METHODS Parents of 464 infants from the STRONG Kids 2 study reported their own and infants' nocturnal sleep duration and other health information (i.e., breastfeeding) at 3, 12, 18, and 24 months postpartum. RESULTS Latent transition models revealed 2 mother-infant sleep profiles exist at 3 to 24 months. The low maternal sleep ( LMS ) pattern was characterized by lower maternal sleep duration than the recommended amount and lower infant sleep duration. The average maternal sleep ( AMS ) pattern was characterized by average maternal sleep duration meeting the recommended standard and average infant sleep duration. Approximately half of the mothers who started in the LMS profile transitioned to the AMS profile after 12 months postpartum. The sleep profiles stabilized after 12 months postpartum with limited transitions across 12 to 24 months. More infant-signaled nighttime wakings, later bedtimes, more infant sleep problems, and more exclusive breastfeeding were predictors of being in the LMS profile. CONCLUSION Mother-infant sleep profiles stabilized after age 12 months, and mother-infant sleep profiles are driven by infant sleep quality during the night. The findings suggest the need to establish a healthy sleep routine for mothers and infants in the first year of life to promote longer-term sleep hygiene.
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Affiliation(s)
- Tianying Cai
- Department of Human Development and Family Studies, University of Illinois at Urbana-Champaign, Urbana, Illinois
| | | | - Sharon M. Donovan
- Department of Food Science and Human Nutrition, University of Illinois at Urbana-Champaign, Urbana, Illinois
| | - Barbara H. Fiese
- Department of Human Development and Family Studies, University of Illinois at Urbana-Champaign, Urbana, Illinois
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9
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Galbally M, Watson SJ, Nguyen T, Boyce P. Fetal SSRI antidepressant exposure and infant sleep: Findings from the MPEWS pregnancy cohort study. Infant Behav Dev 2023; 72:101849. [PMID: 37390573 DOI: 10.1016/j.infbeh.2023.101849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 05/05/2023] [Accepted: 06/03/2023] [Indexed: 07/02/2023]
Abstract
This longitudinal study examines the association between fetal Selective Serotonergic Reuptake Inhibitor antidepressant exposure and infant sleep behaviours at six and 12 months of age and focus on three of the most commonly prescribed antidepressants in pregnancy. This study utilises data on 698 women recruited at less than 20 weeks of pregnancy and are followed up at six and 12 months postpartum. Women were recruited into one of three groups: those taking either sertraline, citalopram or escitalopram antidepressants in pregnancy (n = 85); women with a depressive disorder who were not taking antidepressants (non-medicated depressed, NMD; n = 82); and, and a control group of women (n = 531). At six and 12 months, data were collected on breastfeeding and sleep location and infant sleep was measured using the Brief Infant Sleep Questionnaire. Antidepressants sertraline, escitalopram and citalopram were not associated with increased infant waking or time awake. However, sertraline was associated with longer time for an infant to go to sleep. This study provides reassurance that SSRI antidepressants and, in particular, sertraline, escitalopram and citalopram are not associated with infant sleep behaviours that are commonly regarded as problematic including night waking. Further replication of these findings, including with direct measures of infant sleep, are recommended.
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Affiliation(s)
- Megan Galbally
- School of Clinical Sciences, Monash University, Australia; Health Futures Institute, Murdoch University, Murdoch, Australia; The University of Western Australia Faculty of Medicine Dentistry and Health Sciences, School of Medicine, Australia.
| | - Stuart J Watson
- School of Clinical Sciences, Monash University, Australia; Health Futures Institute, Murdoch University, Murdoch, Australia
| | - Thinh Nguyen
- The University of Western Australia Faculty of Medicine Dentistry and Health Sciences, School of Medicine, Australia; Peel and Rockingham/Kwinana Health Service, Mental Health, Australia
| | - Philip Boyce
- Specialty of Psychiatry, Westmead Institute of Medical Research, Faculty of Medicine and Health, University of Sydney, Australia
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10
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Markovic A, Schoch SF, Huber R, Kohler M, Kurth S. The sleeping brain's connectivity and family environment: characterizing sleep EEG coherence in an infant cohort. Sci Rep 2023; 13:2055. [PMID: 36739318 PMCID: PMC9899221 DOI: 10.1038/s41598-023-29129-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Accepted: 01/31/2023] [Indexed: 02/06/2023] Open
Abstract
Brain connectivity closely reflects brain function and behavior. Sleep EEG coherence, a measure of brain's connectivity during sleep, undergoes pronounced changes across development under the influence of environmental factors. Yet, the determinants of the developing brain's sleep EEG coherence from the child's family environment remain unknown. After characterizing high-density sleep EEG coherence in 31 healthy 6-month-old infants by detecting strongly synchronized clusters through a data-driven approach, we examined the association of sleep EEG coherence from these clusters with factors from the infant's family environment. Clusters with greatest coherence were observed over the frontal lobe. Higher delta coherence over the left frontal cortex was found in infants sleeping in their parents' room, while infants sleeping in a room shared with their sibling(s) showed greater delta coherence over the central parts of the frontal cortex, suggesting a link between local brain connectivity and co-sleeping. Finally, lower occipital delta coherence was associated with maternal anxiety regarding their infant's sleep. These interesting links between sleep EEG coherence and family factors have the potential to serve in early health interventions as a new set of targets from the child's immediate environment.
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Affiliation(s)
- Andjela Markovic
- Department of Psychology, University of Fribourg, Fribourg, Switzerland. .,Department of Pulmonology, University Hospital Zurich, Zurich, Switzerland. .,University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland.
| | - Sarah F Schoch
- Department of Pulmonology, University Hospital Zurich, Zurich, Switzerland.,Center of Competence Sleep & Health Zurich, University of Zurich, Zurich, Switzerland.,Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Reto Huber
- Center of Competence Sleep & Health Zurich, University of Zurich, Zurich, Switzerland.,Child Development Center, University Children's Hospital Zurich, Zurich, Switzerland.,Department of Child and Adolescent Psychiatry and Psychotherapy, Psychiatric Hospital, University of Zurich, Zurich, Switzerland
| | - Malcolm Kohler
- Department of Pulmonology, University Hospital Zurich, Zurich, Switzerland.,Center of Competence Sleep & Health Zurich, University of Zurich, Zurich, Switzerland
| | - Salome Kurth
- Department of Psychology, University of Fribourg, Fribourg, Switzerland.,Department of Pulmonology, University Hospital Zurich, Zurich, Switzerland.,Center of Competence Sleep & Health Zurich, University of Zurich, Zurich, Switzerland
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11
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Rudzik AEF, Robinson-Smith L, Tugwell F, Ball HL. Relationships between postpartum depression, sleep, and infant feeding in the early postpartum: An exploratory analysis. Front Psychiatry 2023; 14:1133386. [PMID: 37032920 PMCID: PMC10079948 DOI: 10.3389/fpsyt.2023.1133386] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Accepted: 03/08/2023] [Indexed: 04/11/2023] Open
Abstract
Introduction The study objectives were to determine the relationships between postpartum depression and maternal and infant sleep parameters and to examine the impact of infant feeding method on infant and maternal sleep and postpartum depression symptomatology. Methods Participants were 61 new mothers aged 18 to 45 years old, and their full-term, normal birth-weight, singleton infants. Participants were recruited from a large teaching hospital in northeast England. Data collection took place in participants' homes. The study used a prospective longitudinal design, with data collected at six, 12 and 18 weeks postpartum. We collected data on total sleep time, longest sleep period, wake after sleep onset, and night waking for mothers and infants objectively from actigraphic records and subjectively from maternal sleep logs. Participants reported on sleep disturbances using the General Sleep Disturbances Scale, on maternal sleepiness, and on depression symptomatology using the Edinburgh Postnatal Depression Scale. Results Scores on the Edinburgh Postnatal Depression Scale and General Sleep Disturbances Scale were consistently correlated with each other (6 weeks r = 0.452, p < 0.01; 12 weeks r = 0.317, p < 0.05; 18 weeks r = 0.493, p < 0.01), and did not correlate with objective measures or subjective reports of maternal or infant sleep. Edinburgh Postnatal Depression Scale scores at six, 12 and 18 weeks were predicted by General Sleep Disturbances Scale, prior Edinburgh Postnatal Depression Scale score, or both, but not by sleep parameters. With regard to infant feeding method, EPDS score was not higher among exclusively breastfeeding than among exclusively formula-feeding participants at any time point (6 weeks t = 0.306, p = 0.762; 12 weeks t = 0.343, p = 0.733; 18 weeks t = 0.426; p = 0.673). Different pathways emerged to predict Edinburgh Postnatal Depression Scale score for exclusively breastfeeding and exclusively formula-feeding women. Discussion Postpartum depression may be associated with disturbed sleep due to negative perception of sleep among depressed women, rather than disrupted sleep causing postpartum depression. With regard to infant feeding method, exclusively breastfeeding women are not more likely to suffer from postpartum depression, and different pathways may predict development of postpartum depression symptoms in exclusively breastfeeding and exclusively formula feeding women.
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Affiliation(s)
- Alanna E. F. Rudzik
- Durham Infancy and Sleep Centre, Durham University, Durham, United Kingdom
- Department of Anthropology, Durham University, Durham, United Kingdom
- *Correspondence: Alanna E. F. Rudzik,
| | - Lyn Robinson-Smith
- Durham Infancy and Sleep Centre, Durham University, Durham, United Kingdom
- Department of Anthropology, Durham University, Durham, United Kingdom
| | - Francesca Tugwell
- Durham Infancy and Sleep Centre, Durham University, Durham, United Kingdom
- Department of Anthropology, Durham University, Durham, United Kingdom
| | - Helen L. Ball
- Durham Infancy and Sleep Centre, Durham University, Durham, United Kingdom
- Department of Anthropology, Durham University, Durham, United Kingdom
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Cai S, Phua DY, Tham EKH, Goh DYT, Teoh OH, Shek LPC, Tan KH, Yap F, Chong Y, Chen H, Broekman BFP, Kramer MS, Meaney MJ. Mid‐pregnancy and postpartum maternal mental health and infant sleep in the first year of life. J Sleep Res 2022; 32:e13804. [PMID: 36511597 DOI: 10.1111/jsr.13804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Revised: 11/15/2022] [Accepted: 11/30/2022] [Indexed: 12/15/2022]
Abstract
Perinatal depression and anxiety are common and associated with sleep problems in the offspring. Depression and anxiety are commonly comorbid, yet often studied independently. Our study used an integrative measure of anxiety and depressive symptoms to examine the associations of maternal mental health (mid-pregnancy and postnatal) with infant sleep during the first year of life. A total of 797 mother-child dyads from the 'Growing Up in Singapore Towards healthy Outcome' cohort study provided infant sleep data at 3, 6, 9 and 12 months of age, using the caregiver reported Brief Infant Sleep Questionnaire. Maternal mental health was assessed at 26-28 weeks gestation and 3 months postpartum using the Edinburgh Postnatal Depression Scale, Beck Depression Inventory and State-Trait Anxiety Inventory. Bifactor modelling with the individual questionnaire items produced a general affect factor score that provided an integrated measure of anxiety and depressive symptoms. Linear mixed models were used to model the sleep outcomes, with adjustment for maternal age, education, parity, ethnicity, sex of the child and maternal sleep quality concurrent with maternal mental health assessment. We found that poorer mid-pregnancy, but not postpartum, maternal mental health was associated with longer wake after sleep onset duration across the first year of life (β = 49, 95% confidence interval 13-85 min). Poor maternal mental health during mid-pregnancy is linked to longer period of night awakening in the offspring during infancy. Interventions that aim to improve maternal antenatal mental health should examine infant sleep outcomes.
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Affiliation(s)
- Shirong Cai
- Agency for Science, Technology and Research (A*STAR) Singapore Institute for Clinical Sciences Singapore Singapore
- Human Potential Translational Research Programme Yong Loo Lin School of Medicine, National University of Singapore Singapore Singapore
| | - Desiree Y. Phua
- Agency for Science, Technology and Research (A*STAR) Singapore Institute for Clinical Sciences Singapore Singapore
| | - Elaine K. H. Tham
- Agency for Science, Technology and Research (A*STAR) Singapore Institute for Clinical Sciences Singapore Singapore
| | - Daniel Y. T. Goh
- Department of Paediatrics Yong Loo Lin School of Medicine, National University of Singapore, National University Health System Singapore Singapore
- Khoo Teck Puat – National University Children's Medical Institute, National University Health System Singapore Singapore
| | - Oon H. Teoh
- Respiratory Medicine Service, Department of Paediatrics KK Women's and Children's Hospital Singapore Singapore
| | - Lynette P. C. Shek
- Agency for Science, Technology and Research (A*STAR) Singapore Institute for Clinical Sciences Singapore Singapore
- Department of Paediatrics Yong Loo Lin School of Medicine, National University of Singapore, National University Health System Singapore Singapore
- Khoo Teck Puat – National University Children's Medical Institute, National University Health System Singapore Singapore
| | - Kok H. Tan
- Duke‐NUS Graduate Medical School Singapore Singapore
- Department of Maternal Fetal Medicine KK Women's and Children's Hospital Singapore Singapore
| | - Fabian Yap
- Department of Paediatric Endocrinology KK Women's and Children's Hospital Singapore Singapore
| | - Yap‐Seng Chong
- Agency for Science, Technology and Research (A*STAR) Singapore Institute for Clinical Sciences Singapore Singapore
- Department of Obstetrics and gynaecology Yong Loo Lin School of Medicine, National University of Singapore, National University Health System Singapore Singapore
| | - Helen Chen
- Duke‐NUS Graduate Medical School Singapore Singapore
- Department of psychological medicine KK Women's and Children's Hospital Singapore Singapore
| | - Birit F. P. Broekman
- Agency for Science, Technology and Research (A*STAR) Singapore Institute for Clinical Sciences Singapore Singapore
- Department of Psychiatry Amsterdam UMC and OLVG location Vrije Universiteit Amsterdam Amsterdam The Netherlands
- Amsterdam Public Health, Mental Health program Amsterdam The Netherlands
| | - Michael S. Kramer
- Department of Epidemiology, Biostatistics and Occupational Health McGill University Faculty of Medicine Montreal Canada
- Department of Pediatrics McGill University Faculty of Medicine Montreal Canada
| | - Michael J. Meaney
- Agency for Science, Technology and Research (A*STAR) Singapore Institute for Clinical Sciences Singapore Singapore
- Department of Psychiatry, Faculty of Medicine McGill University Montreal Canada
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13
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Dai Y, Trout KK, Liu J. Perinatal Physiological and Psychological Risk Factors and Childhood Sleep Outcomes: A Systematic Review and Meta-analysis. J Dev Behav Pediatr 2022; 43:e629-e644. [PMID: 36067425 PMCID: PMC10002289 DOI: 10.1097/dbp.0000000000001123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Accepted: 07/06/2022] [Indexed: 01/01/2023]
Abstract
OBJECTIVES The purpose of this study was to investigate the influence of maternal physiological and psychological factors during pregnancy and after birth on infant and children's sleep outcomes. METHODS Six databases were searched from inception to April 2021. Longitudinal studies that investigated the association of risk factors during and after pregnancy and children's sleep-related outcomes were included. Hedge's g and odds ratio were pooled as effect size with random effects model. RESULTS A total of 32 articles were included. Both prenatal maternal alcohol use (odds ratio [OR] = 1.85, 95% confidence interval [CI]: 1.04-3.28) and tobacco smoking (OR = 1.28, 95% CI: 1.01-1.62) were associated with shorter child sleep duration. Prenatal and postnatal maternal depression symptoms were associated with increased child sleep problems at age 6 months (OR = 1.97, 95% CI: 1.19-3.24, and 2.05, 95% CI: 1.37-3.07, respectively). Prenatal and postnatal maternal major depression disorders were associated with shorter sleep duration (Hedge's g = -0.97, 95% CI: -1.57 to -0.37) and lower sleep efficiency (Hedge's g = -1.44, 95% CI: -1.93 to -0.95). Prenatal anxiety had no impact on child sleep problems (OR = 1.34, 95% CI: 0.86-2.10). CONCLUSION Maternal pregnancy and obstetric factors and psychological factors are potential risk factors of poor child sleep health. Future research is warranted to better understand the impact of these risk factors on long-term child sleep outcomes and their potential mediating mechanisms.
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Affiliation(s)
- Ying Dai
- School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | | | - Jianghong Liu
- School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA
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14
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Zreik G, Asraf K, Haimov I, Tikotzky L. Maternal insomnia and depressive symptoms and early childhood sleep among Arab and Jewish families in Israel. Sleep Med 2022; 100:262-268. [PMID: 36122508 DOI: 10.1016/j.sleep.2022.08.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 08/14/2022] [Accepted: 08/22/2022] [Indexed: 01/12/2023]
Abstract
OBJECTIVES The present study explored the links between maternal insomnia symptoms, maternal depressive symptoms, and young children's sleep quality among two major cultural groups in Israel: Arab and Jewish. We also assessed the prevalence of maternal insomnia and depressive symptoms, in both cultural groups. METHODS Mothers of 497 healthy, typically developing infants and toddlers, ranging in age from 3-36 months, participated in the study: 253 of the mothers were Arab and 244 were Jewish. Mothers completed the Insomnia Severity Index (ISI), the Edinburgh Postnatal Depression Scale (EPDS), and the Brief Infant Sleep Questionnaire. RESULTS For both cultural groups, there were significant positive associations between maternal ISI and EPDS, as well as between maternal ISI and child sleep variables (nighttime wakefulness and perceived child's sleep problems), after controlling for child age. Significant correlations were also found between maternal EPDS and child sleep, after controlling for child age, but these correlations were not significant once controlling for ISI. Cross-cultural differences in prevalence of insomnia and depressive symptoms were found based on the clinical cutoffs of the ISI and EPDS: Arab mothers, compared to Jewish mothers, reported higher levels of insomnia and depressive symptoms, and were more likely to have scores higher than the clinical cutoff on both measures. CONCLUSION Maternal insomnia, depressive symptoms, and child sleep quality are significantly intertwined in both Arab and Jewish families in Israel. The findings highlight the importance of taking these three domains into consideration in research and in clinical assessments of families with young children.
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Affiliation(s)
| | - Kfir Asraf
- The Max-Stern Yezreel Valley College, Israel
| | - Iris Haimov
- The Max-Stern Yezreel Valley College, Israel
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15
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Bechtiger L, Steinhoff A, Dollar JM, Calkins SD, Keane SP, Shriver L, Wideman L, Shanahan L. Maternal Depressive Symptoms and Adolescents' Unhealthy Behavior: A 15-year Longitudinal Study. Pediatrics 2022; 150:e2022056562. [PMID: 36127316 PMCID: PMC9647587 DOI: 10.1542/peds.2022-056562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/06/2022] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES First, to leverage 15 years of longitudinal data, from child ages 2 to 17, to examine whether maternal depressive symptoms in early and middle childhood and in adolescence predict their child's unhealthy behaviors during adolescence. Second, to examine whether the timing of maternal depressive symptoms or specific unhealthy behaviors matter and whether child depressive symptoms and body mass index explain these associations. METHODS Data came from a prospective-longitudinal community sample with multi-informant data (N = 213) from child ages 2 to17. A cumulative adolescent unhealthy behavior index was calculated, summing the presence of poor sleep, poor diet, physical inactivity, sedentary behavior, and smoking. Regression analyses examined associations of maternal depressive symptoms in early childhood (ages 2 to 5), middle childhood (ages 7 to 10), and adolescence (age 15) with adolescents' unhealthy behaviors (ages 16 to17). Indirect effects of child depressive symptoms and body mass index were tested using a path model. RESULTS Adolescents' unhealthy behaviors were common (eg, 2 out of 3 engaged in at least 1 unhealthy behavior). Higher levels of maternal depressive symptoms in middle childhood and adolescence were associated with adolescent engagement in more unhealthy behaviors at ages 16 to 17. Maternal depressive symptoms in early childhood were associated with adolescent unhealthy behaviors through indirect effects involving children's depressive symptoms and continuity of maternal depressive symptoms. CONCLUSIONS Maternal depressive symptoms are associated with the number of adolescent unhealthy behaviors, both directly and indirectly. Promoting mothers' mental health can be crucial for promoting children's health behaviors and health.
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Affiliation(s)
| | | | | | - Susan D. Calkins
- Office of Research and Engagement, University of North Carolina at Greensboro, Greensboro, North Carolina
| | | | | | | | - Lilly Shanahan
- Jacobs Center for Productive Youth Development
- Department of Psychology, University of Zurich, Zurich, Switzerland
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16
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Teti DM, Fronberg KM, Fanton H, Crosby B. Infant sleep arrangements, infant-parent sleep, and parenting during the first six months post-partum. Infant Behav Dev 2022; 69:101756. [PMID: 36027627 DOI: 10.1016/j.infbeh.2022.101756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2021] [Revised: 08/10/2022] [Accepted: 08/15/2022] [Indexed: 11/30/2022]
Abstract
The present study of 124 families examined linkages between patterns of sleep arrangement use across the first 6 months post-partum and (a) family socio-demographics, (b) nighttime sleep of infants, mothers, and fathers, and (c) coparenting distress, and mothers' emotional availability with infants and bedtime. Families were recruited when infants were 1-month-old, and infants were classified, from video data available at 3 and 6 months post-partum, into one of three sleep arrangement pattern groups: Solitary sleep, cosleeping, and cosleeping (at 3 months)-to-solitary sleep (at 6 months). Mothers in cosleeping arrangements were more likely to be at higher socioeconomic risk, non-White, unemployed, and to have completed fewer years of education. Controlling for these variables and for duration of breast feeding and parental depressive and anxiety symptoms, subsequent 3 (sleep arrangement pattern) X 2 (infant age: 3 and 6 months) mixed-model analyses of covariance revealed that sleep arrangement patterns were more robustly linked with maternal sleep than with infant and father sleep. Mothers in cosleeping arrangements experienced more fragmented sleep and greater variability in fragmented sleep relative to mothers of infants in solitary sleep, and fathers in cosleeping arrangements showed greater variability across the week in the number of minutes of nighttime sleep. Cosleeping was associated with mother reports of less positive and more negative coparenting, and mothers in cosleeping arrangements were independently observed to be less emotionally available with their infants at bedtime compared to mothers in the other two sleep arrangement groups. These linkages were largely upheld after statistically controlling for mothers' stated preference for sleep arrangements they were using.
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Affiliation(s)
- Douglas M Teti
- Department of Human Development and Family Studies, The Pennsylvania State University, University Park, PA 16802, United States.
| | - Kaitlin M Fronberg
- Department of Human Development and Family Studies, The Pennsylvania State University, University Park, PA 16802, United States
| | - Heidi Fanton
- Department of Human Development and Family Studies, The Pennsylvania State University, University Park, PA 16802, United States
| | - Brian Crosby
- Department of Psychology, The Pennsylvania State University, University Park, PA 16802, United States
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17
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Hoyniak CP, Bates JE, Catalina Camacho M, McQuillan ME, Whalen DJ, Staples AD, Rudasill KM, Deater-Deckard K. The physical home environment and sleep: What matters most for sleep in early childhood. JOURNAL OF FAMILY PSYCHOLOGY : JFP : JOURNAL OF THE DIVISION OF FAMILY PSYCHOLOGY OF THE AMERICAN PSYCHOLOGICAL ASSOCIATION (DIVISION 43) 2022; 36:757-769. [PMID: 35266772 PMCID: PMC9747092 DOI: 10.1037/fam0000977] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
The physical home environment is thought to play a crucial role in facilitating healthy sleep in young children. However, relatively little is known about how various features of the physical home environment are associated with sleep in early childhood, and some of the recommendations clinicians make for improving child sleep environments are based on limited research evidence. The present study examined how observer and parent descriptions of the child's physical home environment were associated with child sleep, measured using actigraphy and parent's reports, across a year in early childhood. The study used a machine learning approach (elastic net regression) to specify which aspects of the physical home environment were most important for predicting five aspects of child sleep, sleep duration, sleep variability, sleep timing, sleep activity, and latency to fall asleep. The study included 546 toddlers (265 females) recruited at 30 months of age and reassessed at 36 and 42 months of age. Poorer quality physical home environments were associated with later sleep schedules, more variable sleep schedules, shorter sleep durations, and more parent-reported sleep problems in young children. The most important environmental predictors of sleep were room sharing with an adult, bed sharing, and quality of both the child's sleep space and the wider home environment. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
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Affiliation(s)
- Caroline P. Hoyniak
- Department of Psychiatry, Washington University in St. Louis School of Medicine, St. Louis, USA
| | - John E. Bates
- Department of Psychological and Brain Sciences, Indiana University, Bloomington, USA
| | - M. Catalina Camacho
- Department of Psychiatry, Washington University in St. Louis School of Medicine, St. Louis, USA
| | - Maureen E. McQuillan
- Department of Pediatrics, Indiana University School of Medicine, Indianapolis, USA
| | - Diana J. Whalen
- Department of Psychiatry, Washington University in St. Louis School of Medicine, St. Louis, USA
| | | | | | - Kirby Deater-Deckard
- Department of Psychological and Brain Sciences, University of Massachusetts, Amherst, USA
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18
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Maternal Mental Health Symptom Profiles and Infant Sleep: A Cross-Sectional Survey. Diagnostics (Basel) 2022; 12:diagnostics12071625. [PMID: 35885530 PMCID: PMC9319039 DOI: 10.3390/diagnostics12071625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Revised: 06/30/2022] [Accepted: 06/30/2022] [Indexed: 11/17/2022] Open
Abstract
The distinct influence of different, but comorbid, maternal mental health (MMH) difficulties (postpartum depression, anxiety, childbirth-related posttraumatic stress disorder) on infant sleep is unknown, although associations between MMH and infant sleep were reported. This cross-sectional survey aimed: (1) to examine associations between MMH symptoms and infant sleep; (2) to extract data-driven maternal MMH symptom profiles from MMH symptoms; and (3) to investigate the distinct influence of these MMH symptom profiles on infant sleep when including mediators and moderators. Mothers of 3–12-month-old infants (n = 410) completed standardized questionnaires on infant sleep, maternal perception of infant negative emotionality, and MMH symptoms. Data was analyzed using: (1) simple linear regressions; (2) factor analysis; and (3) structural equation modelling. MMH symptoms were all negatively associated with nocturnal sleep duration and only postpartum depression and anxiety symptoms were associated with night waking. Three MMH symptom profiles were extracted: depressive, anxious, and birth trauma profiles. Maternal perception of infant negative emotionality mediated the associations between the depressive or anxious profiles and infant sleep but only for particular infant ages or maternal education levels. The birth trauma profile was not associated with infant sleep. The relationships between MMH and infant sleep may involve distinct mechanisms contingent on maternal symptomatology.
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19
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Cohen MF, Corwin E, Dunlop AL, Brennan PA. Psychological Distress Prospectively Predicts Later Sleep Quality in a Sample of Black American Postpartum Mothers. Behav Sleep Med 2022; 20:442-459. [PMID: 34120540 PMCID: PMC8665932 DOI: 10.1080/15402002.2021.1932499] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Objective: Previous longitudinal studies have demonstrated prospective relationships between maternal sleep quality and subsequent psychological distress in the postpartum period. Despite evidence for prospective relationships between mood and subsequent sleep quality in adult populations, this direction has not been examined in postpartum women. We aimed to test prospective relationships between sleep quality and subsequent psychological distress, as well as the plausible reverse possibility, in a sample of Black American postpartum mothers (n = 146).Participants: Mothers were recruited prenatally from two hospitals in a Southeastern city of the United States. Eligible and interested mothers enrolled in a follow-up study on infant development. Data from the current study were obtained during the follow-up study.Method: Mothers reported on their psychological distress (i.e., anxiety, depression, stress) and sleep quality at 3- and 6-months postpartum. We performed hierarchical linear regressions to explore whether 1) maternal sleep quality at 3-months postpartum would predict maternal psychological distress at 6-months postpartum, after adjustment for mothers' earlier psychological distress, and 2) whether psychological distress at 3-months postpartum would predict maternal sleep quality at 6-months postpartum, after adjustment for mothers' earlier sleep quality.Results: Maternal sleep quality at 3-months postpartum was not a significant predictor of psychological distress at 6-months postpartum. However, maternal psychological distress at 3-months postpartum was a significant predictor of sleep quality at 6-months postpartum.Conclusions: Mothers' psychological distress earlier in the postpartum was a significant predictor of their later sleep quality. Replication is needed in large, prospective studies, with results stratified by race/ethnicity.
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Affiliation(s)
- Madeleine F. Cohen
- Emory University Department of Psychology, 36 Eagle Row, Atlanta, GA 30322, United States of America
| | - Elizabeth Corwin
- Emory University Neil Hodgson Woodruff School of Nursing, 1520 Clifton Road, Atlanta, GA 30322, United States of America
| | - Anne L. Dunlop
- Emory University Neil Hodgson Woodruff School of Nursing, 1520 Clifton Road, Atlanta, GA 30322, United States of America
| | - Patricia A. Brennan
- Emory University Department of Psychology, 36 Eagle Row, Atlanta, GA 30322, United States of America
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20
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Cha K. A Longitudinal Approach to the Relationships Among Sleep, Behavioral Adjustment, and Maternal Depression in Preschoolers. Front Psychol 2022; 13:819657. [PMID: 35496247 PMCID: PMC9043319 DOI: 10.3389/fpsyg.2022.819657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Accepted: 03/15/2022] [Indexed: 12/04/2022] Open
Abstract
This study aimed to investigate the longitudinal associations between children’s sleep duration (SD) and problems (SPs), behavioral adjustment [externalizing behaviors (EB) and internalizing behaviors (IB)], and maternal depressive symptoms (MDS) in preschoolers over a period of 3 years (4–6 years of age). For this purpose, latent growth modeling (LGM) was conducted using 2012(W5) to 2014(W7) data from the National Panel Study on Korean Children (PSKC), while controlling for family contextual factors (i.e., responsive parenting, developmental stimulations, and marital conflict) and child temperament (children’s negative emotionality). First, children who slept longer at four were concurrently associated with lower levels of EB, while more SPs were associated with higher levels of EB and IB, concurrently. Second, greater decreases in SPs were associated with greater decline in EB and IB. Higher levels of MDS at four were associated with higher levels of child EB, IB, and SPs, concurrently. However, no longitudinal associations were found between the rates of change in MDS and children’s sleep and adjustment (EB and IB). Finally, the magnitude of the associations among the variables was greater overall in the SPs models than in the SD models. These findings suggest that addressing sleep problems, rather than sleep duration, seem to be more important in predicting and preventing young children’s adjustment problems and also that more attention should be paid to MDS during preschool years as much as during the postpartum period for better child adjustment outcomes.
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Affiliation(s)
- Kijoo Cha
- Department of Early Childhood Education, Gachon University, Seongnam, South Korea
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21
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Directionality of the associations between bedsharing, maternal depressive symptoms, and infant sleep during the first 15 months of life. Sleep Health 2022; 8:39-46. [PMID: 34922857 PMCID: PMC8821130 DOI: 10.1016/j.sleh.2021.11.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 11/01/2021] [Accepted: 11/03/2021] [Indexed: 02/03/2023]
Abstract
OBJECTIVES To identify predictors of infant sleep arrangement and examine the directionality of the relationships between maternal depressive symptoms, infant sleep problems, and bedsharing. DESIGN Secondary analysis of longitudinal data from the Mothers and Others: Family-Based Obesity Prevention for Infants and Toddlers randomized trial. SETTING Central North Carolina, USA. PARTICIPANTS Four-hundred and twenty-eight predominantly low-income, non-Hispanic Black mother-infant pairs. MEASUREMENTS Data were collected at 28 weeks pregnancy and 1, 3, 6, 9, 12, and 15 months postpartum. Maternal depressive symptoms were measured using the Center for Epidemiological Studies Depression Scale and infant sleep variables were measured using the Brief Infant Sleep Questionnaire. RESULTS The prevalence of reported bedsharing increased from 16.7% at 1 month to 35.6% at 15 months postpartum. Bedsharing was associated with shortened breastfeeding duration and maternal perception of an infant sleep problem. Concurrently, maternal perception of an infant sleep problem, but not presence of maternal depressive symptoms, was associated with an increased likelihood of bedsharing. Longitudinally, neither maternal perception of an infant sleep problem nor presence of maternal depressive symptoms predicted bedsharing. Bedsharing predicted an increased likelihood of maternal perception of an infant sleep problem and presence of maternal depressive symptoms. CONCLUSION Prevalence of bedsharing increased over time and was predictive of maternal depressive symptoms. Providers should discuss the conflicting infant sleep recommendations with their patients and provide safe-sleep guidelines for mothers who intend to bedshare.
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22
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Fronberg KM, Bai S, Teti DM. Household chaos mediates the link between family resources and child sleep. Sleep Health 2022; 8:121-129. [PMID: 34930713 PMCID: PMC8821371 DOI: 10.1016/j.sleh.2021.10.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2021] [Revised: 07/30/2021] [Accepted: 10/06/2021] [Indexed: 02/03/2023]
Abstract
PURPOSE This study examined the mediational role of household chaos in the link between family resources and child sleep outcomes during the transition to kindergarten. PROCEDURES Participants included 230 families of children entering kindergarten (50% female) who participated in an 8-day measurement burst at pre-kindergarten (July-August), early kindergarten (September/October), and mid-kindergarten (November/December). At pre-kindergarten, mothers completFed the Family Resources Scale-Revised (FRS-R), while at pre- and early-kindergarten, trained observers assessed household chaos using the Descriptive In-Home Survey of Chaos-Observer ReporteD (DISCORD). To better understand perturbations in child sleep during this transition, actiwatches (AW Spectrum Plus, Philips/Respironics, Murrysville, PA) were used to measure both child sleep duration and proportion of recommended sleep duration (9+ hours per night) at early- and mid-kindergarten. MAIN FINDINGS Results found that family resources were more clearly predictive of child sleep outcomes than household income. Controlling for quality of coparenting and maternal depressive symptoms, household chaos mediated the link between family resources and child sleep duration at both early and mid-kindergarten, the link between family resources and the proportion of recommended sleep duration in mid-kindergarten, and the change in proportion of recommended sleep from pre-kindergarten to early-kindergarten. CONCLUSIONS Findings highlight household chaos as a mechanism by which family resources, a metric of socioeconomic risk, influences child sleep during the transition to kindergarten.
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Affiliation(s)
- Kaitlin M Fronberg
- Department of Human Development and Family Studies, The Pennsylvania State University, University Park, Pennsylvania, USA
| | - Sunhye Bai
- Department of Human Development and Family Studies, The Pennsylvania State University, University Park, Pennsylvania, USA
| | - Douglas M Teti
- Department of Human Development and Family Studies, The Pennsylvania State University, University Park, Pennsylvania, USA.
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23
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Anders R, Lecuelle F, Perrin C, Ruyter S, Franco P, Huguelet S, Putois B. The Interaction between Lockdown-Specific Conditions and Family-Specific Variables Explains the Presence of Child Insomnia during COVID-19: A Key Response to the Current Debate. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182312503. [PMID: 34886229 PMCID: PMC8656994 DOI: 10.3390/ijerph182312503] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 11/12/2021] [Accepted: 11/23/2021] [Indexed: 01/09/2023]
Abstract
It is still debated whether lockdown conditions in response to the coronavirus disease 2019 (COVID-19) health crisis seriously affected children’s sleep. For young children, some studies identified more insomnia, while others only transient disturbances, or even no effect. Based on the premise of mother–child synchrony, a well-known dynamic established in child development research, we hypothesized that principally, the children whose mothers perceived the lockdown as stressful and/or responded maladaptively, suffered sleep disturbances. The main objective of this study was to identify the family profiles, variables, and lockdown responses most linked to insomnia in young children. The sample consisted of 165 mothers, French vs. Swiss origin (accounting for different lockdown severities), of children 6 months to 5 years old. Validated sleep, stress, and behavior scales were used. Multiple regression, age-matched clustering, and structural equation modeling analyses provided evidence that insomnia in young children is indeed strongly linked to the mother’s reaction to the pandemic and lockdown. Specifically, reactions such as COVID-19 fear/anxiety and obsessive COVID-19 information seeking coincide with heightened vigilance, cascading into reduced child social contact, outings, and increased screen viewing, ultimately culminating in child insomnia and behavioral problems. Mother education level and child day care quality (e.g., home-schooling) were also identified as strong insomnia predictors.
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Affiliation(s)
- Royce Anders
- EMC Laboratory, University of Lyon 2, 69500 Bron, France; (C.P.); (S.R.)
- Institut de Psychologie, University of Lyon 2, 69500 Bron, France
- Correspondence:
| | - Florian Lecuelle
- Lyon Neuroscience Research Center, CNRS UMR 5292-INSERM U1028, University of Lyon 1, 69000 Lyon, France; (F.L.); (P.F.); (B.P.)
- Pediatric Clinical Epileptology, Sleep Disorders and Functional Neurology, Hospital for Women Mothers and Children, CHU of Lyon, 69500 Bron, France
- Faculty of Psychology, Swiss Distance Learning University, 1400 Brig, Switzerland;
| | - Clément Perrin
- EMC Laboratory, University of Lyon 2, 69500 Bron, France; (C.P.); (S.R.)
- Institut de Psychologie, University of Lyon 2, 69500 Bron, France
| | - Swann Ruyter
- EMC Laboratory, University of Lyon 2, 69500 Bron, France; (C.P.); (S.R.)
- Institut de Psychologie, University of Lyon 2, 69500 Bron, France
| | - Patricia Franco
- Lyon Neuroscience Research Center, CNRS UMR 5292-INSERM U1028, University of Lyon 1, 69000 Lyon, France; (F.L.); (P.F.); (B.P.)
- Pediatric Clinical Epileptology, Sleep Disorders and Functional Neurology, Hospital for Women Mothers and Children, CHU of Lyon, 69500 Bron, France
| | - Stéphanie Huguelet
- Faculty of Psychology, Swiss Distance Learning University, 1400 Brig, Switzerland;
| | - Benjamin Putois
- Lyon Neuroscience Research Center, CNRS UMR 5292-INSERM U1028, University of Lyon 1, 69000 Lyon, France; (F.L.); (P.F.); (B.P.)
- Faculty of Psychology, Swiss Distance Learning University, 1400 Brig, Switzerland;
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24
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Children's sleep and fathers' health and wellbeing: A systematic review. Sleep Med Rev 2021; 61:101570. [PMID: 34896729 DOI: 10.1016/j.smrv.2021.101570] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 07/14/2021] [Accepted: 11/03/2021] [Indexed: 11/24/2022]
Abstract
Night-waking is typical across infancy and early childhood, inevitably disrupting family sleep. For some children, sleep problems develop and endure throughout childhood. This systematic review focused on fathers, and synthesised the evidence pertaining to the effects of children's sleep (from birth to 12 years) on fathers' health and wellbeing. A total of 29 studies were included. Key outcomes reported for fathers were: sleep and fatigue; mental and general health; and family functioning. An association between child sleep and father's sleep was observed when child's sleep was measured via actigraphy or paternal report, but not when measured via maternal report, suggesting that mothers may not always be aware of disruptions that awaken fathers. Findings showed poorer child sleep was associated with poorer general health and wellbeing among fathers, however, associations of poor child sleep with depression were fewer, and less frequent than those reported for mothers in the same households. Poor child sleep was negatively associated with the quality of family relationships, both within the couple and between parent and child. Future studies seeking to understand the interplay of child sleep and family wellbeing should apply objective measurement of sleep and integrate formal measures of family dynamics into the study design.
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25
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Peltz J, Rogge R. Adolescent and parent sleep quality mediates the impact of family processes on family members' psychological distress. Sleep Health 2021; 8:73-81. [PMID: 34625392 DOI: 10.1016/j.sleh.2021.08.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Revised: 08/16/2021] [Accepted: 08/26/2021] [Indexed: 01/18/2023]
Abstract
OBJECTIVE To examine the role of adolescents' and their parents' sleep quality as mediators of family-level processes and family members' psychological distress (ie, anxiety/depressive symptoms). DESIGN Short-term prospective design with an initial survey followed by a 7-day twice-daily (morning and evening) diary. SETTING Online survey for high school students and their parents across the United States. PARTICIPANTS A total of 193 adolescent (Mage = 15.7 years old, standard deviation = 0.94; 54.4% female) and parent (Mage = 47.6 years old, standard deviation = 5.4; 80% female) dyads. MEASUREMENT In the initial survey, adolescents reported on family dysfunction, parent-child relationship quality, and parents reported on their own romantic relationship satisfaction. Both adolescents and parents reported their daily levels of sleep quality (morning diaries) and their psychological distress (evening diaries) for 7 days. RESULTS At the level of between-family differences, parents' sleep quality mediated the association between their baseline reports of romantic relationship satisfaction and daily levels of psychological distress. In addition, adolescents' sleep quality mediated the association between family-level dysfunction and their own psychological distress. After controlling for between-family associations, spikes in parents' and/or adolescents' sleep quality on specific mornings predicted corresponding drops in parents' evening reports of psychological distress on those same days. Finally, parents' and adolescents' sleep quality demonstrated significant levels of concordance across the 7 days of the daily diary. CONCLUSIONS Findings underscore the dynamic and tightly related processes within the family system and the important role that sleep plays in linking them with family members' psychological distress.
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Affiliation(s)
- Jack Peltz
- Daemen College Psychology, Amherst, New York, USA.
| | - Ronald Rogge
- University of Rochester, Department of Psychology, Rochester, NY, USA.
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Does Bed Sharing with an Infant Influence Parents’ Sexual Life? A Scoping Review in Western Countries. SEXES 2021. [DOI: 10.3390/sexes2040032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Bed sharing—the sharing of a sleeping surface by parents and children—is a common, yet controversial, practice. While most research has focused on the public health aspect of this practice, much less is known regarding its effect on the marital relationship. The aim of the present study was to conduct a scoping review on the impact of parent–infant bed sharing sleeping practices on the sexual and marital relationship of couples. The qualitative synthesis of six studies on this topic suggests that overall, bed sharing does not exert a significant negative impact on family functioning; when it does, it appears to be related to incongruent parental beliefs and expectations, especially when bed sharing is not an intentional choice of sleep arrangement, and there are other confounding factors such as fatigue and psychological distress. Suggestions for future studies and clinical implications are discussed.
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Herriman RA, Stolfi A, Pascoe JM. Child Sleep and Parent Depressive Symptoms. South Med J 2021; 114:368-372. [PMID: 34075430 DOI: 10.14423/smj.0000000000001262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVES Parent distress and child sleep problems have been associated in earlier research. The present study expands on past research on parent depressive symptoms and their child's sleep. This study examines the relation between parents who screen positive for depressive symptoms and their perception of their child's sleep. METHODS Three hundred sixty-nine English-speaking parents of children ages 3 to 5 years (n = 134) or 6 to 11 years (n = 235) met this study's inclusion criteria within the Southwestern Ohio Ambulatory Research Network (response rate 90%). The validated scales used were the RAND Depression Screener (DS), the Wisconsin Abbreviated Children's Sleep Habits Questionnaire (WCSHQ), and the Jenkins Sleep Questionnaire. Multiple logistic regression was used to determine adjusted odds ratios (AORs) and 95% confidence intervals (CIs) for associations with the WCSHQ. RESULTS In total, 74.3% of the study children were White, 82.4% of respondents were the child's mother, 75.1% had at least some college education, and 54.4% reported an annual income of <$50,000. In total, 54.4% of children were male and 53.8% had public health insurance. Approximately one-fourth of parents had a positive DS and nearly one-third reported sleep problems. Adjusting for child's age and other factors, we found that parents with a positive (vs negative) DS had AOR 2.42 (95% CI 1.38-4.24) for higher WCSHQ scores. Children ages 3 to 5 years (vs 6-11 years) had AOR 2.48 (95% CI 1.56-3.95) for higher WCSHQ scores. CONCLUSIONS Parents with a positive DS were more likely to report sleep problems in their children after adjusting for the child's age. These findings from a diverse sample of US Midwestern families at primary care venues corroborate previous research.
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Affiliation(s)
- Rachael A Herriman
- From the Department of Pediatrics, Wright State University Boonshoft School of Medicine, Dayton, Ohio
| | - Adrienne Stolfi
- From the Department of Pediatrics, Wright State University Boonshoft School of Medicine, Dayton, Ohio
| | - John M Pascoe
- From the Department of Pediatrics, Wright State University Boonshoft School of Medicine, Dayton, Ohio
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Bates RA, Singletary B, Dynia JM, Justice LM. Maternal Mental Health Symptoms and Clusters Predict Toddler Sleep in Low-Income Homes. The Journal of Genetic Psychology 2021; 182:252-268. [PMID: 33949281 DOI: 10.1080/00221325.2021.1910125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
The authors examined the association of maternal mental health symptoms and symptom clusters with the sleeping behaviors of toddlers living in low-income homes. The sample is comprised of 174 racially diverse mother and toddler (15-19 months old) dyads who were participating in a longitudinal birth cohort study. Dyads were initially recruited from Women, Infant, and Children clinics in a Midwestern county of the United States. Maternal mental health symptoms were measured with self-reports of depression (Center for Epidemiological Studies-Depression), parenting stress (Parenting Stress Index Very Short Form), and parenting self-efficacy. Toddler sleeping behaviors were measured with an adaptation of the Tayside Children's Sleep Questionnaire that assessed toddler difficulties in initiating or maintaining sleep (DIMS). Maternal mental health symptom clusters were identified with latent profile analysis and toddler DIMS were regressed on maternal mental health symptoms. We found that 1 SD worse maternal depression, parenting stress, or parenting self-efficacy predicted 0.18-0.24 SD worse toddler DIMS (p < .05). Moreover, we found that the cluster of adverse maternal mental health symptoms predicted nearly 0.75 SD worse toddler DIMS as compared with the cluster of good maternal mental health symptoms (p < .05). These findings provide insight into how maternal mental health symptom clusters may be important in understanding sleep behaviors in early toddlerhood, a sensitive period of sleep development, and underscore the need to support mothers with co-occurring adverse mental health symptoms, as their children may be at higher risk for DIMS.
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Affiliation(s)
- Randi A Bates
- College of Nursing, University of Cincinnati, Cincinnati, Ohio, USA
| | - Britt Singletary
- Crane Center for Early Childhood Research and Policy, The Ohio State University, Columbus, Ohio, USA
| | - Jaclyn M Dynia
- Crane Center for Early Childhood Research and Policy, The Ohio State University, Columbus, Ohio, USA
| | - Laura M Justice
- Crane Center for Early Childhood Research and Policy, The Ohio State University, Columbus, Ohio, USA
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Dias CC, Figueiredo B. Unidirectional and bidirectional links between maternal depression symptoms and infant sleep problems. J Sleep Res 2021; 30:e13363. [PMID: 33900005 DOI: 10.1111/jsr.13363] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Revised: 03/16/2021] [Accepted: 04/01/2021] [Indexed: 01/23/2023]
Abstract
The present study explored (a) the unidirectional and bidirectional links between maternal depression symptoms and infant sleep problems and (b) the moderating role of the infant's sex on these unidirectional and bidirectional links. Mothers (N = 312) completed measures of depression symptoms at the third pregnancy trimester, and measures of depression symptoms and infant sleep problems at 2 weeks, and at 3 and 6 months postpartum. The findings revealed: (a) a main unidirectional link between maternal depression symptoms during the third trimester and infant sleep problems, particularly on infant unsettled sleep and daytime sleepiness at 3 and 6 months; (b) bidirectional links between maternal postpartum depression symptoms and infant unsettled sleep at 2 weeks, 3 and 6 months of life; and (c) the reported links between maternal depression symptoms and infant sleep problems occur specifically in boys and their mothers. Maternal prenatal depression symptoms are linked to infant sleep problems and infant sleep problems are linked to maternal postnatal depression symptoms. Boys are more susceptible to the effects of maternal prenatal and postnatal depression symptoms, and mothers of boys are more susceptible to the effects of boys' sleep problems.
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Williamson AA, Gould R, Leichman ES, Walters RM, Mindell JA. Socioeconomic disadvantage and sleep in early childhood: Real-world data from a mobile health application. Sleep Health 2021; 7:143-152. [PMID: 33678602 DOI: 10.1016/j.sleh.2021.01.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Revised: 01/05/2021] [Accepted: 01/12/2021] [Indexed: 11/27/2022]
Abstract
OBJECTIVES To examine whether increased socioeconomic disadvantage, indexed using a measure of community distress, was associated with variation in caregiver-reported early childhood sleep patterns and problems in a large US sample using a mobile health application (app). DESIGN Cross-sectional. SETTING Data were collected using the free, publicly available Johnson's Bedtime© baby sleep app. PARTICIPANTS A total of 14,980 caregivers (85.1% mothers) of children ages 6-35.9 months (M = 13.88 months; 52.6% boys) participated in this study. MEASURES Caregivers reported on child sleep using the Brief Infant Sleep Questionnaire-Revised. Socioeconomic disadvantage was indexed by zip code using the Distressed Communities Index (DCI), which combines seven US census indicators of socioeconomic disadvantage. DCI scores range from prosperous (lowest quintile) to distressed (highest quintile). RESULTS Socioeconomic disadvantage was significantly associated with later bedtimes, longer sleep onset latency, and shorter nighttime and 24-hour (total) sleep duration, with children living in distressed communities showing the poorest sleep. However, caregivers living in distressed communities reported a significantly lower prevalence of overall child sleep problems (43% vs 58% in prosperous communities), and more confidence in managing child sleep (42% vs 34% in prosperous communities). CONCLUSIONS Children living in the most distressed communities have the poorest reported sleep patterns and bedtime behaviors; however, their caregivers are less likely to report problematic child sleep. These findings highlight the need for community-level sleep health promotion interventions, as well as further investigation of caregiver perceptions about child sleep and sleep health promotion among families living in socioeconomically disadvantaged contexts.
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Affiliation(s)
- Ariel A Williamson
- Sleep Center, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA; Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
| | - Russell Gould
- Johnson & Johnson Consumer Health, Skillman, New Jersey, USA
| | - Erin S Leichman
- Department of Psychology, Saint Joseph's University, Philadelphia, Pennsylvania, USA
| | | | - Jodi A Mindell
- Sleep Center, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA; Department of Psychology, Saint Joseph's University, Philadelphia, Pennsylvania, USA
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Teti DM. Determinants of infant sleep: a call for precise measurement and mechanisms of influence. J Pediatr (Rio J) 2021; 97:109-111. [PMID: 32645289 PMCID: PMC9432079 DOI: 10.1016/j.jped.2020.06.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Affiliation(s)
- Douglas Michael Teti
- The Pennsylvania State University, Department of Human Development and Family Studies, PA, United States.
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Influence of intra- and extrauterine factors on infant sleep in the first 6 months of life. J Pediatr (Rio J) 2021; 97:160-166. [PMID: 32304651 PMCID: PMC9432025 DOI: 10.1016/j.jped.2020.01.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Revised: 01/23/2020] [Accepted: 01/24/2020] [Indexed: 12/17/2022] Open
Abstract
OBJECTIVE Infant sleep problems can affect the child's health. Maternal characteristics have been associated with the quality of infant sleep, but few studies have investigated the impact of intrauterine conditions. The aim of the study was to evaluate the association between adverse intrauterine environments (maternal smoking, hypertension, diabetes, and intrauterine growth restriction) and extrauterine factors on infant sleep in the first 6 months of life. METHODS Prospective cohort study, including singleton and at-term infants. Mothers were interviewed after delivery and at 30 days, 3 months, and 6 months of life. Socioeconomic, breastfeeding, and sleep data were self-reported by mothers using semi-structured interviews. Maternal stress (Perceived Stress Scale) and postpartum depression symptoms (Edinburgh Postpartum Depression Scale) were assessed. RESULTS There was no statistically significant association between intrauterine environments and the sleep of infants of the 359 mother-child dyads investigated. Total infant sleep time decreased from approximately 13-11h from 30 days to 6 months of age (p<0.001) and the longest period of uninterrupted sleep increased from approximately 4-6h during the same period (p<0.001). Breastfed infants slept longer in 24-h periods in the first month, but they woke up more often throughout the night when compared to infants receiving formula. Mothers with depressive symptoms reported increased sleep latency time. CONCLUSIONS Adverse intrauterine environments did not significantly affect sleep measures in the first 6 months of life. Maternal characteristics and practices, however, were associated with infant sleep, suggesting that environmental factors significantly contribute to sleep quality early in life.
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Hazumi M, Nakajima S, Adachi Y. Is 4-month-old infants' night waking affected by mothers' responses to them? A cross-sectional survey in Japan. Nurs Open 2021; 8:882-889. [PMID: 33570288 PMCID: PMC7877162 DOI: 10.1002/nop2.695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2020] [Revised: 09/23/2020] [Accepted: 10/29/2020] [Indexed: 11/09/2022] Open
Abstract
OBJECTIVE To investigate the association between night waking frequency in 3- to 4-month-old infants and mothers' response to them. DESIGN Cross-sectional survey. SAMPLE We examined 663 mothers of infants aged 3-5 months who attended regular health checks for 4 months at 7 public health centres in Japan between September 2006 and March 2007. MEASUREMENTS Mother-reported questionnaires were used, measuring the frequency of infants' night waking and four types of responses by mothers. Using multiple regression, the association between number of wakings and each response was evaluated adjusting for covariates, that is mother's (e.g. feelings of worry and bed-sharing) and infant's (e.g. age and sex) demographic variables. RESULTS The number of wakings was related to "immediately feeding and/or checking diapers" (β = 0.16, p = .002).This response to infants' night waking may be associated with night waking frequency. CONCLUSION Modifying caregiver responses to infants' night waking by reducing immediate feeding or diaper checks could improve infants' night waking frequency.
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Affiliation(s)
- Megumi Hazumi
- Department of Mental Health Policy and EvaluationNational Center of Neurology and PsychiatryNational Institute of Mental HealthTokyoJapan
| | - Shun Nakajima
- National Center for Cognitive Behavior Therapy and researchTokyoJapan
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Ragni B, De Stasio S, Barni D. Fathers and Sleep: A Systematic Literature Review of Bidirectional Links Between Paternal Factors and Children's Sleep in the First Three Years of Life. CLINICAL NEUROPSYCHIATRY 2020; 17:349-360. [PMID: 34909013 PMCID: PMC8629063 DOI: 10.36131/cnfioritieditore20200604] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Objective During childhood, sleep problems are a common concern for parents and families. The literature on children’s sleep documents a strong association between parental factors and infant sleep quality. However, most studies have only examined maternal attitudes and behaviors. To systematically identify and assess the existing literature on the role of fathers in children’s sleep over the first three years of life. Method Studies were identified from January 1993 to July 2020 in four electronic databases, following PRIMSA guidelines. Results The initial search yielded a total of 657 records. Fifty-nine studies were full review, and 26 studies met all inclusion criteria and formed the basis for the review. Studies were divided into thematic groups as a function of the paternal variables they investigated: Extrinsic Parenting factors, Parent-child Interaction Context, and Distal Environmental Influences. Conclusions This review points up a range of paternal variables that can represent risk or protective factors for child sleep. Our results may help parents and healthcare practitioners to identify evidence-based knowledge about sleep. Furthermore, identifying paternal factors that contribute to sleep problems can usefully inform the design of individualized interventions.
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Affiliation(s)
- Benedetta Ragni
- LUMSA University, P.zza delle Vaschette, 101 00193 Rome - Italy, Tel.: +39 06 68422 911
| | - Simona De Stasio
- LUMSA University, P.zza delle Vaschette, 101 00193 Rome - Italy, Tel.: +39 06 68422 911
| | - Daniela Barni
- LUMSA University, P.zza delle Vaschette, 101 00193 Rome - Italy, Tel.: +39 06 68422 911
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Powell CA, Rifas-Shiman SL, Oken E, Krieger N, Rich-Edwards JW, Redline S, Taveras EM. Maternal experiences of racial discrimination and offspring sleep in the first 2 years of life: Project Viva cohort, Massachusetts, USA (1999-2002). Sleep Health 2020; 6:463-468. [PMID: 32331867 DOI: 10.1016/j.sleh.2020.02.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Revised: 12/20/2019] [Accepted: 02/03/2020] [Indexed: 01/10/2023]
Abstract
OBJECTIVE To examine the association of maternal lifetime experiences of racial discrimination with infant sleep duration over the first 2 years of life. DESIGN Prebirth cohort study. SETTING Massachusetts, USA (baseline: 1999-2002). PARTICIPANTS 552 mother-infant dyads in Project Viva, for whom the mother self-identified as being a woman of color. MEASUREMENTS During pregnancy, mothers completed the Experiences of Discrimination survey that measured lifetime experiences of racial discrimination in eight domains. The main outcome was a weighted average of their infants' 24-hour sleep duration from 6 months to 2 years. RESULTS 30% reported 0 domains of racial discrimination, 35% 1-2 domains, and 34% ≥3 domains. Any racial discrimination (≥1 vs. 0 domains) was higher among black (80%) versus Hispanic (58%) or Asian (53%) mothers and the United States versus foreign-born mothers (79% vs. 58%) and was associated with higher mean prepregnancy BMI (26.8 vs. 24.5 kg/m2). Children whose mothers reported ≥3 domains versus 0 domains had shorter sleep duration from 6 months to 2 years in unadjusted analysis (β -18.6 min/d; 95% CI -37.3, 0.0), which was attenuated after adjusting for maternal race/ethnicity and nativity (-13.6 min/d; -33.7, 6.5). We found stronger associations of racial discrimination with offspring sleep at 6 months (-49.3 min/d; -85.3, -13.2) than for sleep at 1 year (-13.5 min/d; -47.2, 20.3) or 2 years (4.2 min/d; -21.5, 29.9). CONCLUSIONS Maternal lifetime experiences of racial discrimination was associated with shorter offspring sleep duration at 6 months, but not with infant's sleep at 1 and 2 years of age.
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Affiliation(s)
- Chloé A Powell
- Division of Chronic Disease Research Across the Lifecourse (CoRAL), Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA; Division of Vascular Surgery, Department of Surgery, University of Michigan, Ann Arbor, MI
| | - Sheryl L Rifas-Shiman
- Division of Chronic Disease Research Across the Lifecourse (CoRAL), Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA.
| | - Emily Oken
- Division of Chronic Disease Research Across the Lifecourse (CoRAL), Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA; Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA
| | - Nancy Krieger
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA
| | - Janet W Rich-Edwards
- Division of Women's Health, Department of Medicine, Brigham and Women's Hospital, Boston, MA; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA; Connors Center for Women's Health and Gender Biology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA
| | - Susan Redline
- Department of Medicine, Harvard Medical School, Brigham and Women's Hospital, and Beth Israel Deaconess Medical School, Boston, MA
| | - Elsie M Taveras
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA; Division of General Academic Pediatrics, Department of Pediatrics, Massachusetts General Hospital for Children, Boston, MA
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Halal CS, Bassani DG, Santos IS, Tovo-Rodrigues L, Del-Ponte B, Silveira MF, Bertoldi AD, Barros FC, Nunes ML. Maternal perinatal depression and infant sleep problems at 1 year of age: Subjective and actigraphy data from a population-based birth cohort study. J Sleep Res 2020; 30:e13047. [PMID: 32285520 DOI: 10.1111/jsr.13047] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2019] [Revised: 03/17/2020] [Accepted: 03/19/2020] [Indexed: 12/16/2022]
Abstract
This study used data from 2,222 mothers and infants participating in a population-based birth cohort to verify whether maternal depression in the perinatal period was associated with poor infant sleep. Mothers who scored ≥13 points on the Edinburgh Postnatal Depression Scale at 16-24 weeks of gestation and/or 3 months after delivery were considered perinatally depressed. The main outcome variable was poor infant sleep at 12 months of age, defined as >3 night wakings, nocturnal wakefulness >1 hr or total sleep duration <9 hr. Infant sleep data were obtained with the Brief Infant Sleep Questionnaire (BISQ) and 24-hr actigraphy monitoring. Prevalence of perinatal depression in the sample was 22.3% (95% confidence interval [CI], 20.5-24.0). After Poisson regression, infants of depressed mothers showed an adjusted relative risk (RR) of 1.44 (95% CI, 1.00-2.08; p = .04) for >3 night wakings with questionnaire-derived data. When actigraphy data were analysed, no association was found between perinatal depression and poor infant sleep (adjusted RR, 1.20; 95% CI, 0.82-1.74; p = .35). In conclusion, although mothers in the depressed group were more likely to report more night wakings, objective data from actigraphy did not replicate this finding. Dysfunctional cognition, maternal behavioural factors and sleep impairment associated with perinatal depression may affect the mother's impression of her infant's sleep.
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Affiliation(s)
- Camila S Halal
- PhD Program of Medicine and Health Sciences, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, Brazil.,Conceição Hospital Group, Hospital Criança Conceição, Porto Alegre, Brazil
| | - Diego G Bassani
- Centre for Global Child Health, The Hospital for Sick Children and Department of Paediatrics, University of Toronto, Toronto, ON, Canada.,Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
| | - Iná S Santos
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
| | | | - Bianca Del-Ponte
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
| | - Mariangela F Silveira
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
| | - Andréa D Bertoldi
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
| | - Fernando C Barros
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil.,Graduate Studies Program in Health and Behaviour, Universidade Católica de Pelotas, Pelotas, Brazil
| | - Magda L Nunes
- Division of Neurology, Pontifícia Universidade Católica do Rio Grande do Sul School of Medicine, Brain Institute (BRAIns), Porto Alegre, Brazil
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Ben-Zion H, Volkovich E, Meiri G, Tikotzky L. Mother-Infant Sleep and Maternal Emotional Distress in Solo-Mother and Two-Parent Families. J Pediatr Psychol 2020; 45:181-193. [PMID: 31923314 DOI: 10.1093/jpepsy/jsz097] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2019] [Revised: 11/22/2019] [Accepted: 11/26/2019] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE This study examined for the first time mother-infant sleep and emotional distress in solo mother families compared with two-parent families and explored whether the links between mother-infant sleep and maternal emotional distress differ as a function of family structure. METHODS Thirty-nine solo-mother families and 39 two-parent families, with an infant within the age range of 6-18 months participated in the study. Actigraphy and sleep diaries were used to assess maternal and infant sleep at home. Mothers completed questionnaires to assess maternal depressive and anxiety symptoms, social support, sleeping arrangements, breastfeeding, and demographics. RESULTS Solo mothers were older and more likely to breastfeed and share a bed with their infants than married mothers. There were no significant differences between the groups in mother-infant sleep and maternal emotional distress, while controlling for maternal age, breastfeeding, and sleeping arrangements. Family structure had a moderating effect on the associations between maternal emotional distress and mother-infant sleep. Only in solo-mother families, higher maternal emotional distress was associated with lower maternal and infant sleep quality. CONCLUSIONS Our findings suggest that, although there are no significant differences in maternal and infant sleep between solo-mother families and two-parent families, the strength of the associations between maternal emotional distress and both infant and maternal sleep quality are stronger in solo-mother families, compared with two-parent families. Hopefully, understanding which aspects of parenting may contribute to the development of sleep problems in solo-mother families could be helpful in tailoring interventions to this growing population.
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Affiliation(s)
| | - Ella Volkovich
- Department of Psychology, Ben-Gurion University of the Negev
| | - Gal Meiri
- Faculty of Health Sciences, Ben-Gurion University of the Negev
| | - Liat Tikotzky
- Department of Psychology, Ben-Gurion University of the Negev
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The Mother-Infant Sleep Nexus: Night-Time Experiences in Early Infancy and Later Outcomes. THE MOTHER-INFANT NEXUS IN ANTHROPOLOGY 2020. [DOI: 10.1007/978-3-030-27393-4_9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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Knappe S, Pfarr AL, Petzoldt J, Härtling S, Martini J. Parental Cognitions About Sleep Problems in Infants: A Systematic Review. Front Psychiatry 2020; 11:554221. [PMID: 33408648 PMCID: PMC7779594 DOI: 10.3389/fpsyt.2020.554221] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Accepted: 11/20/2020] [Indexed: 12/17/2022] Open
Abstract
Introduction: Parental cognitions may directly and indirectly contribute to infant sleep outcomes. This review provides a systematic up-to-date overview of the associations between parental cognitions and infant sleep problems with special emphasis on temporal relationships and the content of parental cognitions. Methods: A systematic literature research in PubMed and Web of Science Core Collection sensu Liberati and PRISMA guidelines was carried out in March 2020 using the search terms (parent* AND infant* AND sleep* problem*), including studies with correlational or control group designs investigating associations between parental cognitions and sleep problems in children aged 1-6 years. Results: Twenty-three studies (published from 1985 to 2016) met inclusion criteria, of which 14 reported group differences or associations between parental sleep-related cognitions and child sleep outcomes. Nine papers additionally reported on the role of general parental child-related cognitions not directly pertaining to sleep. Findings from longitudinal studies suggest that parental cognitions often preceded child sleep problems. Cognitions pertaining to difficulties with limit-setting were especially prevalent in parents of poor sleepers and were positively associated with both subjective and objective measures of child sleep outcomes. Conclusions: Parental cognitions appear to play a pivotal role for the development and maintenance of sleep problems in young children, arguing that parents' attitudes and beliefs regarding child sleep inadvertently prompts parental behavior toward adverse sleep in offspring. Associations are however based on maternal reports and small to moderate effect sizes. Thus, additional parental factors such as mental health or self-efficacy, as well as additional offspring factors including temperamental dispositions and regulatory abilities, require consideration in further studies.
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Affiliation(s)
- Susanne Knappe
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - Anna-Lisa Pfarr
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - Johanna Petzoldt
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - Samia Härtling
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany.,University of Meißen (FH) and Centre of Further Education, Meißen, Germany
| | - Julia Martini
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany.,Department of Psychiatry and Psychotherapy, Faculty of Medicine, Carl Gustav Carus University Hospital, Technische Universität Dresden, Dresden, Germany
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Wroe J, Campbell L, Fletcher R, McLoughland C. “What am I thinking? Is this normal?” A cross-sectional study investigating the nature of negative thoughts, parental self-efficacy and psychological distress in new fathers. Midwifery 2019; 79:102527. [DOI: 10.1016/j.midw.2019.08.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2019] [Revised: 08/06/2019] [Accepted: 08/11/2019] [Indexed: 10/26/2022]
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Ragni B, De Stasio S, Barni D, Gentile S, Giampaolo R. Parental Mental Health, Fathers' Involvement and Bedtime Resistance in Infants. Ital J Pediatr 2019; 45:134. [PMID: 31675994 PMCID: PMC6824034 DOI: 10.1186/s13052-019-0731-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Accepted: 10/13/2019] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Around the age of 6 months, difficulties in settling to sleep and frequent night awakenings are generally occurring in 20 to 30% of infants. According to the transactional model parental factors can play a significant role in influencing infant sleep development. The purpose of the current study was to explore the combined effect of infants' factors (temperament and sleep onset problems), and parental factors (parental mental health in terms of post-partum affective disorders, consistent bedtime routines and fathers' involvement at bedtime), on infant bedtime difficulties (e.g. fussing, crying or protesting), including both maternal and paternal perspectives. METHODS Sixty Italian intact two-parent families of infants (34 boys and 26 girls) ageing from 8 to 12 months (M = 10.73, SD = 2.54) were enrolled in the study. The parents filled out self-report questionnaires to measure the aforementioned variables. To investigate which infant and parental factors predicted infants' bedtime difficulties, two multiple linear regressions (MR), one for fathers and one for mothers, and relative weight analyses (RWA) were conducted. RESULTS With regard to infants' bedtime difficulties reported by fathers (R2 = .35) they were explained by infant involvement in constant bedtime routines (β = -.35, p = .030) and paternal involvement at bedtime (β = -.45, p = .007). Instead infants' bedtime difficulties reported by mothers (R2 = .32) were explained by minutes the child taken to fall asleep (β = .24, p = .04), infant involvement in constant bedtime routines (β = -.31, p = .01) and bedtime paternal involvement (β = -.27, p = .05). CONCLUSIONS The main results of this study emphasized the protective role of consistent bedtime routines and bedtime paternal involvement in reducing infants' bedtime difficulties perceived both from mothers and fathers. Future research could help to raise awareness and improve understanding of the familial influences on children's sleep, providing recommendations for educating families, school professionals, healthcare providers, and the general public on risk and protective factors that could play a meaningful role in infants and children's developing sleep patterns.
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Affiliation(s)
- Benedetta Ragni
- LUMSA University, P.zza delle Vaschette, 101 00193 Rome, Italy
| | | | - Daniela Barni
- LUMSA University, P.zza delle Vaschette, 101 00193 Rome, Italy
| | - Simonetta Gentile
- Unit of Clinical Psychology, Bambino Gesù Children’s Hospital, Piazza S. Onofrio 4, 00165 Rome, Italy
| | - Rosaria Giampaolo
- Outpatient’s Unit, University Department of Pediatrics, Bambino Gesù Children’s Hospital, Piazza S. Onofrio 4, 00165 Rome, Italy
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Camerota M, Propper CB, Teti DM. Intrinsic and extrinsic factors predicting infant sleep: Moving beyond main effects. DEVELOPMENTAL REVIEW 2019. [DOI: 10.1016/j.dr.2019.100871] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Cimon-Paquet C, Tétreault É, Bernier A. Early parent–child relationships and child sleep at school age. JOURNAL OF APPLIED DEVELOPMENTAL PSYCHOLOGY 2019. [DOI: 10.1016/j.appdev.2019.101057] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Grimes M, Camerota M, Propper CB. Neighborhood deprivation predicts infant sleep quality. Sleep Health 2019; 5:148-151. [PMID: 30928114 PMCID: PMC6943834 DOI: 10.1016/j.sleh.2018.11.001] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2018] [Revised: 10/26/2018] [Accepted: 11/02/2018] [Indexed: 10/27/2022]
Abstract
OBJECTIVES The current study examined the relationship between neighborhood deprivation and infant sleep at 3 months of age. METHODS Neighborhood and sleep data were collected from 80 African American infants and their caregivers. A composite neighborhood deprivation score was created using census data. Infant sleep was measured via 7 nights of actigraphy monitoring when infants were 3 months of age. Current analyses considered the average number of infant night wakings as an index of sleep quality. Multilevel models were used, in which children (level 1) were nested within census tracts (level 2). RESULTS Controlling for level 1 covariates, greater neighborhood deprivation (b = 0.07, P < .01), was associated with poorer infant sleep, as characterized by a greater number of wakings during the nighttime sleep period. CONCLUSIONS Findings suggest that infants who reside in communities marked by higher deprivation experience poorer quality sleep, even after controlling for family-level factors.
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Affiliation(s)
- Melissa Grimes
- Department of Psychology and Neuroscience, The University of North Carolina at Chapel Hill, Campus Box 3270, 235 E. Cameron Street, Chapel Hill, NC 27599, USA.
| | - Marie Camerota
- Department of Psychology and Neuroscience, The University of North Carolina at Chapel Hill, Campus Box 3270, 235 E. Cameron Street, Chapel Hill, NC 27599, USA
| | - Cathi B Propper
- Center for Developmental Science, The University of North Carolina at Chapel Hill, East Franklin Street, Suite 200, CB#8115, Chapel Hill, NC 27599, USA
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Peltz JS, Rogge RD. The Moderating Role of Parents' Dysfunctional Sleep-Related Beliefs Among Associations Between Adolescents' Pre-Bedtime Conflict, Sleep Quality, and Their Mental Health. J Clin Sleep Med 2019; 15:265-274. [PMID: 30736878 DOI: 10.5664/jcsm.7630] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2018] [Accepted: 10/22/2018] [Indexed: 02/06/2023]
Abstract
STUDY OBJECTIVES The current study's aim was to examine the indirect effect of parent-child pre-bedtime arguing about the bedtime process on adolescents' symptoms of anxiety and depression via the mediating role of adolescents' sleep quality. In addition, this study sought to test this mediation model across different levels of both parents' and children's dysfunctional sleep-related beliefs (ie, moderated mediation). METHODS A total of 193 adolescent (mean age = 15.7 years, standard deviation [SD] = .94; 54.4% female) and parent dyads completed both baseline, online surveys, and online 7-day, twice-daily sleep diaries. Parents (mean age = 47.6 years, SD = 5.4; 80% female) reported daily for 7 days on the intensity of any conflict regarding the adolescents' bedtime process, and adolescents completed daily reports of their sleep duration and quality (morning diary) and their anxiety and depressive symptoms (evening diary). RESULTS Results suggested that adolescent sleep quality mediated the indirect association between parent-child pre-bedtime arguing and adolescents' anxiety and depressive symptoms. Furthermore, this mediation model was moderated by parents' dysfunctional sleep-related beliefs. Only in families with parents reporting either average or above-average (+1 SD) levels of dysfunctional beliefs did this mediation model emerge as significant. CONCLUSIONS Results provide further evidence for the essential role of the family environment in adolescent sleep and well-being, and they suggest that parents' dysfunctional sleep-related cognitions put adolescents at risk for a negative cascade stemming from arguing over bedtime to poor-quality sleep and its negative consequences on their mental health.
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Affiliation(s)
- Jack S Peltz
- Daemen College, Amherst, New York.,The University of Rochester Medical Center, Rochester, New York
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Voltaire ST, Teti DM. Early nighttime parental interventions and infant sleep regulation across the first year. Sleep Med 2018; 52:107-115. [DOI: 10.1016/j.sleep.2018.07.013] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2018] [Revised: 07/29/2018] [Accepted: 07/30/2018] [Indexed: 01/08/2023]
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Garthus-Niegel S, Horsch A, Bickle Graz M, Martini J, von Soest T, Weidner K, Eberhard-Gran M. The prospective relationship between postpartum PTSD and child sleep: A 2-year follow-up study. J Affect Disord 2018; 241:71-79. [PMID: 30098473 DOI: 10.1016/j.jad.2018.07.067] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2018] [Revised: 06/11/2018] [Accepted: 07/22/2018] [Indexed: 11/26/2022]
Abstract
BACKGROUND The main aim of this study was to examine the prospective impact of maternal postpartum PTSD on several standardized child sleep variables two years postpartum in a large, population-based cohort of mothers. Moreover, we investigated the influence of numerous potential confounding maternal and child factors. Finally, we tested potential reverse temporal associations between child sleep eight weeks postpartum and maternal PTSD symptoms two years postpartum. METHODS This study is part of the population-based Akershus Birth Cohort, a prospective cohort study at Akershus University Hospital, Norway. Data from the hospital's birth record, from questionnaires at 17 weeks gestation, eight weeks and two years postpartum were used. At two years postpartum, 39% of the original participants could be retained, resulting in a study population of n = 1480. All child sleep variables significantly correlated with postpartum PTSD symptoms were entered into multiple linear regression analyses, adjusting for confounding factors. RESULTS Postpartum PTSD symptoms were related to all child sleep variables, except daytime sleep duration. When all significant confounding factors were included into multivariate regression analyses, postpartum PTSD symptoms remained a significant predictor for number and duration of night wakings (β = 0.10 and β = 0.08, respectively), duration of settling time (β = 0.10), and maternal rating of their child's sleep problems (β = 0.12, all p<.01. Child sleep at eight weeks postpartum was not significantly related to maternal sleep two years postpartum when controlling for postpartum PTSD at eight weeks. LIMITATIONS Child outcomes were based on maternal reporting and might be influenced by maternal mental health. CONCLUSIONS Our results showed for the first time that maternal postpartum PTSD symptoms were prospectively associated with less favorable child sleep, thus increasing the risk of developmental or behavioral problems through an indirect, but treatable pathway. Early detection and treatment of maternal postpartum PTSD may prevent or improve sleep problems and long-term child development.
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Affiliation(s)
- Susan Garthus-Niegel
- Department of Psychotherapy and Psychosomatic Medicine, Faculty of Medicine,Technische Universität Dresden, Fetscherstr. 74, 01307 Dresden, Germany; Department of Child Health, Norwegian Institute of Public Health, P.O. box 222 Skøyen, 0213 Oslo, Norway.
| | - Antje Horsch
- Department Woman-Mother-Child, Faculty of Biology and Medicine, Lausanne University Hospital, Rue du Bugnon 21, CH-1011 Lausanne, Switzerland; Institute of Higher Education and Research in Healthcare (IUFRS), Faculty of Biology and Medicine, Lausanne University and Lausanne University Hospital, Rue du Bugnon 21, CH-1011 Lausanne, Switzerland
| | - Myriam Bickle Graz
- Department Woman-Mother-Child, Faculty of Biology and Medicine, Lausanne University Hospital, Rue du Bugnon 21, CH-1011 Lausanne, Switzerland
| | - Julia Martini
- Department of Child and Adolescent Psychiatry, Faculty of Medicine, Technische Universität Dresden, Fetscherstr. 74, 01307 Dresden, Germany
| | - Tilmann von Soest
- Department of Psychology, University of Oslo, P.O. box 1094, Blindern, 0317 Oslo, Norway
| | - Kerstin Weidner
- Department of Psychotherapy and Psychosomatic Medicine, Faculty of Medicine,Technische Universität Dresden, Fetscherstr. 74, 01307 Dresden, Germany
| | - Malin Eberhard-Gran
- Department of Child Health, Norwegian Institute of Public Health, P.O. box 222 Skøyen, 0213 Oslo, Norway; HØKH, Research Centre, Akershus University Hospital, P.O. box 1000, 1478 Lørenskog, Norway; Institute of Clinical Medicine, Campus Ahus, University of Oslo, P.O. box 1171, Blindern, 0318 Oslo, Norway
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Ball HL, Douglas PS, Kulasinghe K, Whittingham K, Hill P. The Possums Infant Sleep Program: parents' perspectives on a novel parent-infant sleep intervention in Australia. Sleep Health 2018; 4:519-526. [PMID: 30442320 DOI: 10.1016/j.sleh.2018.08.007] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2018] [Revised: 07/06/2018] [Accepted: 08/16/2018] [Indexed: 01/06/2023]
Abstract
AIM To evaluate parental perspectives on the acceptability and usefulness of a 'cued-care' approach to infant sleep implemented in an Australian primary care setting. The Possums Infant Sleep Program aims to empower parents to better understand their infant's sleep and their responses to it, and optimize healthy function of the infant's biological sleep regulators to protect against excessive night-waking. METHODS The evaluation was undertaken by an independent infant sleep researcher, with no previous involvement in the Possums program. Parents' experiences of the sleep intervention were captured using a mixed methods approach involving (a) group discussions of sleep issues between parents and clinic staff, (b) discussions with parents who volunteered to provide face-to-face feedback, and (c) an online survey designed in light of the information gained from a and b. A one-year audit of clinic registrations provided contextual data. RESULTS Sixty-four clinic clients fully (45) or partially (19) provided answers to survey questions. Respondents were primarily mothers, mean age 34, with a postgraduate qualification and high family income. Their term infants were predominantly breastfed and attended the clinic for feeding and/or sleeping difficulties across the first year of life. Almost all embraced the Possums approach, describing it as challenging and life changing. Audit data confirmed the survey sample reflected the general clinic population. CONCLUSIONS The Possums Infant Sleep Program was acceptable to parents, and highly valued. Recipients reported reduced stress, less concern about perceived sleep problems (frequent night-waking, short-day-time naps, delayed sleep onset), and better quality of life.
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Affiliation(s)
- Helen L Ball
- Durham University, Infancy & Sleep Centre, Department of Anthropology, Dawson Building, Lower Mountjoy, Durham DH1 3LE, United Kingdom.
| | - Pamela S Douglas
- Possums Education, PO Box 5139 West End, Queensland 4101, Australia; Discipline of General Practice, The University of Queensland, Brisbane, Australia; Maternity, Newborn and Families Research Collaborative, MHIQ, Griffith University, Brisbane, Australia
| | | | - Koa Whittingham
- Queensland Cerebral Palsy and Rehabilitation Research Centre (QCPRRC), UQ Child Health Research Centre, The University of Queensland, Centre for Children's Health Research, Brisbane, Australia
| | - Peter Hill
- School of Public Health, The University of Queensland, Brisbane, Australia
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Galbally M, Watson SJ, Teti D, Lewis AJ. Perinatal maternal depression, antidepressant use and infant sleep outcomes: Exploring cross-lagged associations in a pregnancy cohort study. J Affect Disord 2018; 238:218-225. [PMID: 29886202 DOI: 10.1016/j.jad.2018.05.025] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2018] [Revised: 04/12/2018] [Accepted: 05/18/2018] [Indexed: 02/06/2023]
Abstract
BACKGROUND Both perinatal depression and infant sleep problems are common concerns in many communities, with these problems often coinciding. Findings in this area conflict and much of the research relies on poor measures of sleep and/or depression. Adding to this complexity is the rise in antidepressant treatment for perinatal maternal depression and no previous study has examined the relationship between such exposure and infant sleep. METHODS This study draws on four waves of data (early pregnancy and third trimester, and six and 12 months postpartum) from 264 women in the Mercy Pregnancy and Emotional Wellbeing Study, a prospective pregnancy cohort study of women recruited in early pregnancy in Melbourne, Australia. Cross-lagged regression models were used to examine reciprocity of longitudinal effects between depressive symptoms and infant sleep. RESULTS Maternal antepartum depression and antidepressant use were not significant predictors of infant sleep problems. Likewise, infant sleep problems were not significant predictors of postpartum maternal depression. However, maternal cognitions about infant sleep, characterised by maternal expectations to immediately attend to their crying child, did demonstrate positive reciprocal effects with infant nocturnal waking between six and 12 months postpartum. LIMITATIONS Infant sleep outcomes were reported by the mother and the sample were predominantly Anglophone, restricting generalizability of the models to other cultures. CONCLUSIONS Maternal depression and antidepressant use were not found to be significant factors in infant sleep problems and, likewise, infant sleep problems were not associated with maternal depression. However, postpartum maternal cognitions around six months postpartum regarding limit-setting at night may predict increases in later nocturnal infant signaling.
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Affiliation(s)
- Megan Galbally
- School of Psychology and Exercise Science, Murdoch University, Australia; School of Medicine, University of Notre Dame, Australia; King Edward Memorial Hospital, Australia.
| | - Stuart J Watson
- School of Psychology and Exercise Science, Murdoch University, Australia; School of Medicine, University of Notre Dame, Australia
| | - Doug Teti
- Human Development and Family Studies, The Pennsylvania State University, USA
| | - Andrew J Lewis
- School of Psychology and Exercise Science, Murdoch University, Australia
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Whitesell CJ, Crosby B, Anders TF, Teti DM. Household chaos and family sleep during infants' first year. JOURNAL OF FAMILY PSYCHOLOGY : JFP : JOURNAL OF THE DIVISION OF FAMILY PSYCHOLOGY OF THE AMERICAN PSYCHOLOGICAL ASSOCIATION (DIVISION 43) 2018; 32:622-631. [PMID: 29781634 PMCID: PMC6072580 DOI: 10.1037/fam0000422] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
Household chaos has been linked with dysregulated family and individual processes. The present study investigated linkages between household chaos and infant and parent sleep, a self-regulated process impacted by individual, social, and environmental factors. Studies of relations between household chaos and child sleep have focused on older children and teenagers, with little attention given to infants or parent sleep. This study examines these relationships using objective measures of household chaos and sleep while controlling for, respectively, maternal emotional availability at bedtime and martial adjustment, in infant and parent sleep. Multilevel modeling examined mean and variability of sleep duration and fragmentation for infants, mothers, and fathers when infants were 1, 3, 6, 9, and 12 months (N = 167). Results indicated infants in higher chaos homes experienced delays in sleep consolidation patterns, with longer and more variable sleep duration, and greater fragmentation. Parent sleep was also associated with household chaos such that in higher chaos homes, mothers and fathers experienced greater variability in sleep duration, which paralleled infant findings. In lower chaos homes, parents' sleep fragmentation mirrored infants' decreasingly fragmented sleep across the first year and remained lower at all timepoints compared to parents and infants in high chaos homes. Collectively, these findings indicate that after controlling for maternal emotional availability and marital adjustment (respectively) household chaos has a dysregulatory impact on infant and parent sleep. Results are discussed in terms of the potential for chaos-induced poor sleep to dysregulate daytime functioning and, in turn, place parent-infant relationships at risk. (PsycINFO Database Record
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Affiliation(s)
- Corey J Whitesell
- Department of Human Development & Family Studies, The Pennsylvania State University
| | - Brian Crosby
- Department of Psychology, The Pennsylvania State University
| | | | - Douglas M Teti
- Department of Human Development & Family Studies, The Pennsylvania State University
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