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van de Sande M, Gerards S, L'Hoir MP, Gabrio A, Reijs RP, Tissen I, van Dam SW, Alberts F, Meertens RM. Promoting healthy sleep in 0-2-year-old infants: a study protocol for the development and mixed method evaluation of a sleep health program tailored to Dutch youth healthcare regions. BMC Public Health 2024; 24:1913. [PMID: 39014342 PMCID: PMC11253352 DOI: 10.1186/s12889-024-19258-3] [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: 03/28/2024] [Accepted: 06/24/2024] [Indexed: 07/18/2024] Open
Abstract
BACKGROUND Sleep problems are common among infants and can have a serious impact on the health and wellbeing of both child and parents. To sustainably promote infant sleep on a population level, it is necessary to develop evidence-based programs that can be implemented on a large scale. The Youth Health Care setting, with its focus on prevention, child health promotion and services widely available for parents, can be a suitable setting to do so. Currently however, sleep health promotion in this setting seems to be suboptimal. To promote healthy infant sleep on a population level, programs need to be accessible and comprehensible for all parents, including parents with limited (health) literacy. Therefore, this study aims to develop, implement and evaluate a program called 'Sleep on number 1', that is tailored to Dutch Youth Health Care, to sustainably promote healthy sleep in 0-2-year-old infants. METHODS The program was developed based on co-creation with parents and Youth Health Care professionals, evidence-based behaviour change theories and sleep health promotion methods. Program effectiveness is investigated with a quasi-experimental study design comparing the program group with the care as usual control group. Participants consist of parents of 0-2-year-old children. Primary outcome is infant sleep quality at the age of 10 weeks and 6, 9, 14 and 24 months, measured with a sleep diary. The primary data analysis focuses on night awakenings at 9 months. Secondary outcomes focus on parental behaviour regarding infant sleep, related behavioural determinants and parental satisfaction with Youth Health Care sleep advice. Program effectiveness is analysed using a linear mixed-model in case of data clustering, and an independent samples T-test or linear regression in case no substantial clustering effects are found. A mixed methods process evaluation is performed with parents and Youth Health Care professionals, assessing program reach, adoption, implementation, maintenance and working mechanisms. DISCUSSION The 'Sleep on number 1' program is an evidence-based sleep health program for 0-2-year-old children, tailored to Dutch Youth Health Care. If effective, this program has the potential to improve infant sleep on a population level. TRIAL REGISTRATION ISRCTN, ISRCTN27246394, registered on 10/03/2023. https://www.isrctn.com/ISRCTN27246394 .
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Affiliation(s)
- Mpw van de Sande
- Department of Health Promotion, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, P.O. Box 616, Maastricht, 6200 MD, The Netherlands.
| | - Smpl Gerards
- Department of Health Promotion, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, P.O. Box 616, Maastricht, 6200 MD, The Netherlands
| | - M P L'Hoir
- Department of Global Nutrition, Division of Human Nutrition and Health, Wageningen University and Research, P.O. Box 17, Wageningen, 6700 AA, The Netherlands
- Public Health Service North-East-Gelderland, P.O. Box 3, Zutphen, 7200 AA, The Netherlands
| | - A Gabrio
- Department of Methodology and Statistics, CAPHRI Care and Public Health Research Institute, Maastricht University, P.O. Box 616, Maastricht, 6200 MD, The Netherlands
| | - R P Reijs
- Department of Social Medicine, CAPHRI Care and Public Health Research Institute, Maastricht University, P.O. Box 616, Maastricht, 6200 MD, The Netherlands
- Department of Youth Health Care, Public Health Service South Limburg, P.O. box 33, Heerlen, 6400 AA, The Netherlands
| | - I Tissen
- Public Health Service Limburg-North, P.O. box 1150, Venlo, 5900 BD, The Netherlands
| | - S W van Dam
- Department of Youth Health Care, Public Health Service South Limburg, P.O. box 33, Heerlen, 6400 AA, The Netherlands
| | - Fhgy Alberts
- Public Health Service Brabant-Southeast, P.O. box 8684, KR Eindhoven, 5605, The Netherlands
| | - R M Meertens
- Department of Health Promotion, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, P.O. Box 616, Maastricht, 6200 MD, The Netherlands
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Nóblega M, Retiz O, Nuñez del Prado J, Bartra R. Maternal Stress Mediates Association of Infant Socioemotional Development with Perinatal Mental Health in Socioeconomically Vulnerable Peruvian Settings. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:844. [PMID: 39063421 PMCID: PMC11276598 DOI: 10.3390/ijerph21070844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/20/2024] [Revised: 06/22/2024] [Accepted: 06/26/2024] [Indexed: 07/28/2024]
Abstract
Increased maternal mental health during the perinatal period has been widely associated with a variety of positive outcomes for both mothers and infants. However, no studies in Peru have yet focused on studying maternal mental health and related psychological variables during this stage. Thus, the aim of this study was to test a model to associate a mother's parental stress with infant socioemotional difficulties and maternal mental health. The sample included 988 mothers of infants aged 6 to 18 months from Peru, all from socioeconomically vulnerable settings. The findings showed that infant socioemotional difficulties were associated with poorer maternal mental health through the mother's parental stress (χ2(7) = 28.89, p < 0.001, CFI = 0.98, RMSEA = 0.06, SRMR = 0.03). These results provide a better understanding of the key elements associated with maternal mental health during the perinatal period in Peru and offer valuable insights for developing interventions and support strategies for socioeconomically vulnerable mothers and their young children.
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Affiliation(s)
- Magaly Nóblega
- Department of Psychology, Pontifical Catholic University of Peru, Lima 15088, Peru; (O.R.); (J.N.d.P.); (R.B.)
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Bante A, Ayele G, Alamirew B, Ahmed M. Regulatory problems and associated factors among infants in Arba Minch health and demographic surveillance system sites, southern Ethiopia. PLoS One 2024; 19:e0305722. [PMID: 38889163 PMCID: PMC11185483 DOI: 10.1371/journal.pone.0305722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Accepted: 06/03/2024] [Indexed: 06/20/2024] Open
Abstract
INTRODUCTION Infant regulatory problems are a common source of concern for parents, and they increase the risk of impaired infant-caregiver bonding. Despite their impact, they are often overlooked in Ethiopia. Hence, this study aimed to determine the prevalence and associated factors of infant regulatory problems in Arba Minch Health and Demographic Surveillance System sites in southern Ethiopia. METHODS A community-based cross-sectional study was conducted among 451 mother-infant pairs from February 15 to March 15, 2022. Regulatory problems were assessed using diagnostic interviews for regulatory problems. The data was collected using an open data kit Android application and analyzed with Stata version 17.0. Bivariable and multivariable logistic regression analyses were computed to identify factors associated with each infant regulatory problem. Statistical significance was declared at a p-value < 0.05. RESULTS In this study, four hundred forty-nine mother-infant pairs were involved, with a response rate of 99.5%. The prevalence of excessive crying, feeding problems, and sleeping difficulties was 14.03% [95% CI: 10.95, 17.59], 20.04% [95% CI: 16.44, 24.05], and 13.59% [95% CI: 10.55, 17.11], respectively. Attending primary education (AOR: 2.54, 95% CI: 1.22, 5.32), high perceived social support (AOR: 0.32, 95% CI: 0.12, 0.89), feeding problems (AOR: 5.0, 95% CI: 2.65, 9.45), and depression, anxiety, and stress (DAS) symptoms (AOR: 2.67, 95% CI: 1.19, 5.98) were associated with excessive crying. In addition, a family size of above five (AOR: 1.82, 95% CI: 1.03, 3.22), excessive crying (AOR: 3.76, 95% CI: 1.85, 7.65), sleeping problems (AOR: 2.29, 95% CI: 1.13, 4.65), comorbid DAS symptoms (AOR: 3.42, 95% CI: 1.64, 7.11), alcohol abuse (AOR: 1.89, 95% CI: 1.04, 3.42), and late initiation of complementary feeding (AOR: 2.67, 95% CI: 1.22, 5.88) were associated with feeding problems. Furthermore, attending primary education (AOR: 2.35, 95% CI: 1.16, 4.77), feeding problems (AOR: 3.47, 95% CI: 1.86, 6.48), and comorbid DAS symptoms (AOR: 3.23, 95% CI: 1.53, 6.84) were associated with sleeping problems. CONCLUSIONS Approximately one-third of infants encountered at least one regulatory problem. Level of education, perceived social support, feeding problems, and DAS symptoms were associated with excessive crying. Large family sizes, excessive crying, sleeping problems, comorbid DAS symptoms, alcohol abuse and, late initiation of complementary feeding increase the likelihood of feeding problems. Moreover, attending primary education, feeding problems, and comorbid DAS symptoms increase the odds of sleeping problems. Continuous guidance and support on infant soothing techniques, cognitive and behavioral therapy, and counselling on appropriate coping strategies for postpartum women are imperative to reduce the burden of infant regulatory problems.
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Affiliation(s)
- Agegnehu Bante
- School of Nursing, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Gistane Ayele
- School of Public Health, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Birhanu Alamirew
- School of Nursing, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Muluken Ahmed
- School of Medicine, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
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Massare BA, Irvin CN, Hicks SD. Increased Sleep Latency and Decreased Sleep Duration are Associated With Elevated Risk of Bed Sharing Among Mother-Infant Dyads. Clin Pediatr (Phila) 2024; 63:708-713. [PMID: 37488931 PMCID: PMC11070114 DOI: 10.1177/00099228231188211] [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] [Indexed: 07/26/2023]
Abstract
Bed sharing increases risk of sleep-related infant deaths. We hypothesized that infant sleep difficulties increase bed sharing, independent of social determinants of health (SDOH). In total, 191 mother-infant dyads in a prospective, longitudinal cohort study completed the Brief Infant Sleep Questionnaire at 1, 4, 6, and 12 months. Sleep characteristics at 1 month (latency, duration, night awakenings) were compared between dyads with/without bed sharing in the first 12 months. Infants who participated in bed sharing slept fewer hours at night (7.1 ± 1.7 hours vs 8.3 ± 1.5 hours, P = .001, d = -0.79), and took longer to fall asleep (0.7 ± 0.6 hours vs 0.5 ± 0.5 hours, P = .021, d = 0.43), even when controlling for SDOH variables that influence bed sharing. Maternal perception of sleep problems did not differ between groups (P = .12). Our findings suggest that infants with quantifiable sleep difficulties at 1 month are more likely to bed share.
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Affiliation(s)
- Brittany A. Massare
- Department of Pediatrics, Penn State College of Medicine, Penn State Milton S. Hershey Medical Center, Hershey, PA, USA
| | - Christine N. Irvin
- Department of Pediatrics, Penn State College of Medicine, Penn State Milton S. Hershey Medical Center, Hershey, PA, USA
| | - Steven D. Hicks
- Department of Pediatrics, Penn State College of Medicine, Penn State Milton S. Hershey Medical Center, Hershey, PA, USA
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Lim ESM, Williams J, Vlaskovsky P, Ireland DJ, Geddes DT, Perrella SL. Maternal Reports of Preterm and Sick Term Infants' Settling, Sleeping and Feeding in the 9 Months after Discharge from Neonatal Nursery: An Observational Study. CHILDREN (BASEL, SWITZERLAND) 2024; 11:655. [PMID: 38929234 PMCID: PMC11202291 DOI: 10.3390/children11060655] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/23/2024] [Revised: 05/21/2024] [Accepted: 05/27/2024] [Indexed: 06/28/2024]
Abstract
The effects of preterm birth, neonatal morbidities and environmental influences on infant sleep development is an important yet under-researched topic, with little known about normative sleep for infants born sick or preterm. The aim of this prospective, observational longitudinal study was to evaluate maternal perceptions and degree of bother with infant sleep behaviours and feeding outcomes across the first 9 months after discharge for sick/preterm infants cared for in the neonatal intensive care unit (NICU) and for healthy term-born infants. This paper reports outcomes for the sick/preterm cohort (I = 94) that were recruited from two NICUs in Perth, Western Australia. Total bother scores were on average 20.2% higher at 9 months than at two weeks post-discharge (p < 0.001). Increased night waking frequency, evening settling duration and crying duration were all positively associated with total bother scores. Maternal confidence scores were negatively associated with maternal bother scores; with each unit increase in confidence, maternal bother decreased by 8.5% (p < 0.001). Covariates such as birth gestation, breastfeeding status and multiple births were not associated with maternal bother. Families may benefit from additional support when experiencing increased night waking frequency and crying and settling durations in the first 9 months after discharge from NICU.
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Affiliation(s)
- Emma Shu Min Lim
- School of Biomedical Sciences, The University of Western Australia, Perth, WA 6009, Australia
| | - Julie Williams
- Neonatology Clinical Care Unit, King Edward Memorial Hospital, Subiaco, WA 6008, Australia
| | - Philip Vlaskovsky
- Department of Mathematics and Statistics, School of Physics, Mathematics and Computing, The University of Western Australia, Perth, WA 6009, Australia
| | - Demelza J. Ireland
- School of Biomedical Sciences, The University of Western Australia, Perth, WA 6009, Australia
| | - Donna T. Geddes
- School of Molecular Sciences, The University of Western Australia, Perth, WA 6009, Australia
- ABREAST Network, Perth, WA 6000, Australia
- UWA Centre for Human Lactation Research and Translation, Perth, WA 6009, Australia
| | - Sharon L. Perrella
- School of Molecular Sciences, The University of Western Australia, Perth, WA 6009, Australia
- ABREAST Network, Perth, WA 6000, Australia
- UWA Centre for Human Lactation Research and Translation, Perth, WA 6009, Australia
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Garrido F, González-Caballero JL, García P, Gianni ML, Garrido S, González L, Atance V, Raffaeli G, Cavallaro G. Association between co-sleeping in the first year of life and preschoolers´ sleep patterns. Eur J Pediatr 2024; 183:2111-2119. [PMID: 38351212 PMCID: PMC11035441 DOI: 10.1007/s00431-024-05429-2] [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: 10/18/2023] [Revised: 01/07/2024] [Accepted: 01/09/2024] [Indexed: 03/27/2024]
Abstract
This study aimed to investigate the association between co-sleeping practiced during the first year of life and preschoolers' sleep patterns. A cross-sectional study including toddlers was designed to analyze their sleep patterns. The Brief Infant Sleep Questionnaire, validated in Spanish, was used to measure sleep quality. A latent class analysis was performed to identify qualitative subgroups in the sample and explore the effects of co-sleeping. The sleep patterns of 276 children were analyzed. A total of 181 (65%) parents reported having practiced co-sleeping with their children. The latent class analysis identified a two-class solution with two different sleep patterns. One of them showed a worse quality sleep pattern, which had a significant association with having practiced co-sleeping during the first year of life, and with the fact that they were still sleeping in the parents' room, among other characteristics related to co-sleeping and parental concerns. Breastfeeding also showed association with a worse quality sleep pattern. Conclusion: Based on the present findings, co-sleeping during the first year of life appears to be associated with poor sleep patterns in young preschoolers. What is Known: • Co-sleeping shows benefits for infants and parents, mainly facilitating successful breastfeeding. • Literature on the effect of co-sleeping in lately sleep quality in children and their parents is very limited. What is New: • Co-sleeping practiced during the first year of life could be associated with a worse sleep pattern measured with BISQ-E tool. • A balance between the correct practice of co-sleeping and the achievement of a healthy sleep routine in preschool should probably be part of parents' health education.
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Affiliation(s)
- Felipe Garrido
- Department of Pediatrics, Clínica Universidad de Navarra. Calle Marquesado de Santa Marta, 1, Madrid (28227), Spain.
| | | | | | - Maria-Lorella Gianni
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, 20122, Milan, Italy
- Neonatal Intensive Care Unit. Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico. 20122, Milan, Italy
| | - Silvia Garrido
- Department of Pediatrics, Clínica Universidad de Navarra, Madrid (28227), Spain
| | - Lucía González
- Department of Pediatrics, Clínica Universidad de Navarra, Madrid (28227), Spain
| | - Verónica Atance
- Department of Pediatrics, Clínica Universidad de Navarra, Madrid (28227), Spain
| | - Genny Raffaeli
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, 20122, Milan, Italy
- Neonatal Intensive Care Unit. Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico. 20122, Milan, Italy
| | - Giacomo Cavallaro
- Neonatal Intensive Care Unit. Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico. 20122, Milan, Italy
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Boedker I, Ball HL, Richter M, South TL, Roberts SGB. Construction of the Views oN Infant Sleep (VNIS) Questionnaire. Early Hum Dev 2024; 191:105989. [PMID: 38513547 DOI: 10.1016/j.earlhumdev.2024.105989] [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: 01/18/2024] [Revised: 03/14/2024] [Accepted: 03/14/2024] [Indexed: 03/23/2024]
Abstract
Parents' beliefs about infant sleep behaviour vary over time and across cultures. No validated instrument exists to understand parents' pre- and postnatal views on infant sleep behaviours, which may influence their caregiving decisions. The Views oN Infant Sleep Questionnaire (VNIS) will be a tool to assess parents' beliefs in order to facilitate tailored perinatal care, increase the reliability of postnatal self-report measures, allow for cross-cultural comparisons, and provide a baseline for researchers to use in longitudinal studies. We recruited an online sample of 971 female participants who were resident in the United Kingdom, at least 28 weeks pregnant, and at least 18 years of age. The initial questionnaire consisted of 31 questions about infant independence, night-waking, infant feeding, touch, and safety, and items were rated on a 5-point Likert scale. The item pool was reduced to 12 using principal component analysis and a structure was found for the three components "Closeness", "Independence", and "Night-waking". Overall, these results suggest that the VNIS can provide a brief scale to measure different aspects of individuals' beliefs about infant sleep. In further research the VNIS needs to be validated with a confirmatory factor analysis in another sample, and to be tested as a cross-cultural instrument.
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Affiliation(s)
- Ingrid Boedker
- School of Psychology, Liverpool John Moores University, Liverpool, United Kingdom.
| | - Helen L Ball
- Department of Anthropology, Durham University, Durham, United Kingdom
| | - Michael Richter
- School of Psychology, Liverpool John Moores University, Liverpool, United Kingdom
| | - Tina L South
- School of Nursing and Allied Health, Liverpool John Moores University, Liverpool, United Kingdom
| | - Sam G B Roberts
- School of Psychology, Liverpool John Moores University, Liverpool, United Kingdom
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Yazdi M, Bemanalizadeh M, Kelishadi R. Persian version of brief infant sleep questionnaire (BISQ): a psychometric evaluation. BMC Pediatr 2024; 24:181. [PMID: 38491410 PMCID: PMC10941427 DOI: 10.1186/s12887-024-04666-6] [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: 10/12/2023] [Accepted: 02/22/2024] [Indexed: 03/18/2024] Open
Abstract
BACKGROUND The high prevalence of sleep problems and their negative consequences on children and parents highlight the need to design early screening instruments to evaluate sleep problems in early childhood. We aimed to determine the validity and reliability of the Brief Infant Sleep Questionnaire (BISQ) among the Iranian population. METHODS AND MATERIALS This study included 646 one-year-old infants by random sampling from the PERSIAN birth cohort study. Following the forward-backward translation of the BISQ, its psychometric properties, including construct validity in terms of concurrent and convergent validities as well as reliability, were evaluated. RESULTS The CVIs and CVR ranged between 0.8 and 1.00 for all items. Therefore, we keep all the items of the original version of the BISQ in the Persian BISQ. Concurrent validity was assessed by comparing items of the Persian BISQ among different maternal views regarding their infant's sleep. All BISQ items were significantly different among the two levels of maternal view about the infant's sleep problem except daytime sleep duration. The convergent validity of the BISQ was evaluated by calculating the correlation between BISQ items and the ISQ (infant sleep questionnaire) total score as a similar tool. ISQ score was adequately correlated with nocturnal sleep latency and the number of waking at night (rs ranged from 0.59 to 0.72). In addition, the associations of mothers' and infants' demographic variables and nutritional and gestational variables with BISQ items were presented to confirm construct validity. Strong correlations were found between the repeated sleep measures for sleep arrangement, sleep position, and sleep situation (kappa ranged from 0.65 to 0.84), nocturnal sleep duration, daytime sleep duration number of wakings at night, night waking duration, nocturnal sleep latency and sleep-onset time (ICC ranged 0.91 to 0.99). CONCLUSION The Persian version of the BISQ is a reliable and valid measure for assessing sleep problems in infants. It would be helpful to be utilized for the early diagnosis of infants' sleep problems.
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Affiliation(s)
- Maryam Yazdi
- Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-Communicable Disease, Isfahan University of Medical Science, Isfahan, Iran
| | - Maryam Bemanalizadeh
- Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-Communicable Disease, Isfahan University of Medical Science, Isfahan, Iran.
| | - Roya Kelishadi
- Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-Communicable Disease, Isfahan University of Medical Science, Isfahan, Iran.
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Xie Y, Feeney BC. A narrative review of research linking non-sexual social touch to sleep quality. J Sleep Res 2024:e14174. [PMID: 38382911 DOI: 10.1111/jsr.14174] [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: 10/26/2023] [Revised: 01/30/2024] [Accepted: 01/31/2024] [Indexed: 02/23/2024]
Abstract
This narrative review describes the current state of the literature that has examined associations between non-sexual social touch (i.e., affectionate touch, touch therapies, touch with animals and inanimate objects that mimic social touch) and sleep quality. It also highlights areas for future research to clarify the links and to identify underlying mechanisms. Most existing studies have focussed on and shown positive effects of touch therapies (e.g., massage, therapeutic touch) on sleep quality in clinical populations. Although there are fewer studies examining how other forms of social touch are linked with sleep quality, the existing research provides preliminary evidence supporting affectionate touch (e.g., hugging, skin-to-skin contact) and tactile contact with animals (e.g., dogs) and objects that mimic social touch (e.g., robots, weighted blankets) as predictors of better sleep quality, while touch deprivation and touch aversion are associated with worse sleep quality. Informed by the existing literature, we additionally reviewed potential relational-cognitive (e.g., felt-security) and neurobiological (e.g., oxytocin) mechanisms likely to underlie associations between social touch and sleep quality. Overall, current research supports associations between non-sexual social touch and sleep quality. However, future research is needed to establish these links for specific forms of social touch (and in various populations), to test explanatory mechanisms, and to identify boundary conditions. Understanding associations between non-sexual social touch and sleep quality can inform the development of touch-based interventions to improve sleep quality and health.
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Affiliation(s)
- Yuxi Xie
- Department of Psychology, Carnegie Mellon University, Pittsburgh, Pennsylvania, USA
| | - Brooke C Feeney
- Department of Psychology, Carnegie Mellon University, Pittsburgh, Pennsylvania, USA
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Sırtbaş-Işık G, Porsnok D, Yardımcı-Lokmanoğlu BN, Mutlu A. Sleep characteristics, early spontaneous movements, and developmental functioning in preterm infants in the early postnatal period. Sleep Med 2024; 114:151-158. [PMID: 38184924 DOI: 10.1016/j.sleep.2023.12.016] [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: 08/09/2023] [Revised: 12/15/2023] [Accepted: 12/18/2023] [Indexed: 01/09/2024]
Abstract
OBJECTIVE This study aimed to investigate the following: (i) sleep characteristics in preterm infants at 9-20 weeks of corrected age, and (ii) differences in early spontaneous movements and developmental functioning results between the groups based on some sleep characteristics. METHODS Seventy-four preterm infants (36 female) were included. Sleep characteristics were assessed according to the Brief Infant Sleep Questionnaire (BISQ). The infants were divided into two groups based on total sleep duration: less than 12 h (38 infants), and 12 h and more (36 infants). Video recordings were made for the General Movements Assessment (GMA) and evaluated using the Motor Optimality Score for 3- to 5-Month-Old-Infants-Revised (MOS). Cognitive, language, and motor development were assessed using the Bayley Scales of Infant and Toddler Development, Third Edition (Bayley-III). RESULTS The total sleep duration of all preterm infants (mean ± SD) was 11.8 ± 3.3 h. Infants who had absent fidgety movements slept less than 12 h, and fidgety movements differed between the groups (p = 0.012). Infants who slept 12 h or more had significantly higher MOS (p = 0.041), cognitive (p = 0.002), language (p < 0.001), and motor (p = 0.002) development results. Infants who snored had lower MOS (p = 0.001), cognitive (p = 0.004), language (p = 0.002), and motor (p = 0.001) development results. Infants with fewer than three nocturnal awakenings had significantly higher Bayley-III cognitive (p = 0.007), language (p = 0.032), and motor (p = 0.005) domain results. Prone and supine sleeping positions showed higher motor domain results than lateral positions (p = 0.001). CONCLUSIONS Sleep in preterm infants might be a key factor in early developmental functioning processes and nervous system integrity. Even in the first months of life, there are substantial differences in cognitive, language, and motor development in association with sleep characteristics.
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Affiliation(s)
- Gülsen Sırtbaş-Işık
- Hacettepe University, Faculty of Physical Therapy and Rehabilitation, Developmental and Early Physiotherapy Unit, Ankara, Türkiye.
| | - Doğan Porsnok
- Hacettepe University, Faculty of Physical Therapy and Rehabilitation, Developmental and Early Physiotherapy Unit, Ankara, Türkiye.
| | - Bilge Nur Yardımcı-Lokmanoğlu
- Hacettepe University, Faculty of Physical Therapy and Rehabilitation, Developmental and Early Physiotherapy Unit, Ankara, Türkiye.
| | - Akmer Mutlu
- Hacettepe University, Faculty of Physical Therapy and Rehabilitation, Developmental and Early Physiotherapy Unit, Ankara, Türkiye.
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Pendo K, Swisher VS, Leman TY, Rissman AJ, Peris TS, Piacentini J, Snorrason I, Ricketts EJ. Clinical Characteristics, Sleep, and Temperament in Infants and Young Children with Problematic Hair Pulling and Skin Picking. COGNITIVE THERAPY AND RESEARCH 2024; 48:119-136. [PMID: 38450328 PMCID: PMC10914340 DOI: 10.1007/s10608-023-10435-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/20/2023] [Indexed: 03/08/2024]
Abstract
Background This study examined clinical characteristics of problematic hair pulling (HP) and skin picking (SP) in infants and young children and their association with self-soothing, sleep, and temperament. Methods An internet survey of parents/caregivers of 0-5-year-olds (n = 384 with data analyzed, of whom 26 experienced HP, 62 experienced SP, and 302 were controls free of HP and SP) assessed demographics and medical history, HP and SP characteristics, contextual factors, self-soothing, sleep patterns, and temperament. Participants were recruited through both HP and SP advocacy and support webpages and general webpages (e.g., parenting groups). Descriptive statistics, chi-square tests of independence, independent samples t-test clinically characterized HP, SP, and control groups. Logistic regression and one-way analysis of covariance controlled for sex and age in analyses. Results HP and SP rates were 6.1% (n = 26) and 14.5% (n = 62), respectively. SP presented in 23.1% of children with HP, and HP presented in 9.7% of children with SP. Mean HP and SP onset occurred at 12.2 (SD = 11.2) and 24.1 (SD = 15.8) months, respectively. Contextual factors, including boredom, upset, and awake-in-bed were common in HP and SP. Common caregiver responses included distracting the child, moving the hand away, and telling the child to stop. Few caregivers sought professional help for the child. Children with HP engaged in more hair twirling than controls, and children with SP engaged in more nail biting than controls. Children with HP, but not SP, had more sleep disturbance than controls. In terms of temperament, children with HP displayed sensitivity to stimuli, children with SP exhibited low persistence, and both HP and SP groups displayed serious, observant mood relative to controls. Conclusions Findings expand clinical understanding of HP and SP in children aged 0-5 and provide targets (contextual factors, sleep, sensory sensitivity, persistence, and mood) for behavioral interventions. Low rates of treatment seeking highlight the need for expansion of clinical guidelines for HP and SP in this age range.
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Affiliation(s)
- Kevin Pendo
- Herbert Wertheim College of Medicine, Florida International University
| | - Valerie S Swisher
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles
| | - Talia Y Leman
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles
| | - Ariel J Rissman
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles
- Department of Psychology, Adelphi University
| | - Tara S Peris
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles
| | - John Piacentini
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles
| | - Ivar Snorrason
- Department of Psychiatry, Massachusetts General Hospital/Harvard Medical School
| | - Emily J Ricketts
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles
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Chae SM, Yeo JY, Han SY, Chung NR, Hwang JH. Infant sleep interventions with sleep measurements using actigraphy: A systematic review. Int J Nurs Pract 2024; 30:e13196. [PMID: 37671613 DOI: 10.1111/ijn.13196] [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: 04/18/2022] [Revised: 08/07/2023] [Accepted: 08/10/2023] [Indexed: 09/07/2023]
Abstract
AIM This review investigated the outcomes and methodological quality of infant sleep intervention studies utilizing actigraphy. BACKGROUND Parents need appropriate support for infant sleep from nurses. There are few methodological reports of actigraphy in infant sleep intervention studies that objectively measure infant sleep in a natural setting. DESIGN This was a systematic review study. DATA SOURCES Ovid MEDLINE, Embase, Cochrane, CINAHL and PsycINFO were searched from database establishment to 30 December 2021. REVIEW METHODS This systematic review utilized the Cochrane Collaboration review guidelines. RESULTS Eleven sleep intervention studies were reviewed. Three used extinction-based behavioural interventions, and eight included parental education programs. The infant sleep interventions positively affected the sleep outcomes of both infants and parents. Fairly consistent effects were found on infants' number of awakenings and sleep onset latency. However, parental psychosocial outcomes were inconsistent. All studies reported device placement, the algorithm for analysis, the use of a sleep diary and number of days/nights, but external movements affecting infants' sleep records were insufficiently reported. Only two studies had a low risk of bias. CONCLUSIONS The infant sleep interventions had positive effects on both infants and their parents. Comprehensive methodological considerations are required for more standardized assessments using actigraphy for infant sleep evaluation.
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Affiliation(s)
- Sun-Mi Chae
- Seoul National University College of Nursing, The Research Institute of Nursing Science, Seoul, South Korea
| | - Ji-Young Yeo
- College of Nursing, Hanyang University, Seoul, South Korea
| | - Soo-Yeon Han
- Department of Nursing, Bucheon University, Bucheon, South Korea
| | - Na-Ry Chung
- Seoul National University Hospital, Seoul, South Korea
| | - Ji-Hye Hwang
- Department of Nursing, Bucheon University, Bucheon, South Korea
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de Groot ER, Ryan MA, Sam C, Verschuren O, Alderliesten T, Dudink J, van den Hoogen A. Evaluation of Sleep Practices and Knowledge in Neonatal Healthcare. Adv Neonatal Care 2023; 23:499-508. [PMID: 37595146 PMCID: PMC10686278 DOI: 10.1097/anc.0000000000001102] [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] [Indexed: 08/20/2023]
Abstract
BACKGROUND Developmental care is designed to optimize early brain maturation by integrating procedures that support a healing environment. Protecting preterm sleep is important in developmental care. However, it is unclear to what extent healthcare professionals are aware of the importance of sleep and how sleep is currently implemented in the day-to-day care in the neonatal intensive care unit (NICU). PURPOSE Identifying the current state of knowledge among healthcare professionals regarding neonatal sleep and how this is transferred to practice. METHODS A survey was distributed among Dutch healthcare professionals. Three categories of data were sought, including (1) demographics of respondents; (2) questions relating to sleep practices; and (3) objective knowledge questions relating to sleep physiology and importance of sleep. Data were analyzed using Spearman's rho test and Cramer's V test. Furthermore, frequency tables and qualitative analyses were employed. RESULTS The survey was completed by 427 participants from 34 hospitals in 25 Dutch cities. While healthcare professionals reported sleep to be especially important for neonates admitted in the NICU, low scores were achieved in the area of knowledge of sleep physiology. Most healthcare professionals (91.8%) adapted the timing of elective care procedures to sleep. However, sleep assessments were not based on scientific knowledge. Therefore, the difference between active sleep and wakefulness may often be wrongly assessed. Finally, sleep is rarely discussed between colleagues (27.4% regularly/always) and during rounds (7.5%-14.3% often/always). IMPLICATIONS Knowledge about sleep physiology should be increased through education among neonatal healthcare professionals. Furthermore, sleep should be considered more often during rounds and handovers.
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Affiliation(s)
- Eline R. de Groot
- Department of Neonatology, Wilhelmina Children's Hospital (Mss de Groot and Sam and Drs Alderliesten, Dudink, and van den Hoogen), and Brain Centre Rudolf Magnus (Drs Alderliesten and Dudink), University Medical Center Utrecht, Utrecht, the Netherlands; INFANT Centre, University College Cork, Cork, Ireland (Ms Ryan); Department of Neonatology, Cork University Maternity Hospital, Cork, Ireland (Ms Ryan); and UMC Utrecht Brain Center and Center of Excellence for Rehabilitation Medicine (Dr Verschuren), Utrecht University (Dr van den Hoogen), Utrecht, the Netherlands
| | - Mary-Anne Ryan
- Department of Neonatology, Wilhelmina Children's Hospital (Mss de Groot and Sam and Drs Alderliesten, Dudink, and van den Hoogen), and Brain Centre Rudolf Magnus (Drs Alderliesten and Dudink), University Medical Center Utrecht, Utrecht, the Netherlands; INFANT Centre, University College Cork, Cork, Ireland (Ms Ryan); Department of Neonatology, Cork University Maternity Hospital, Cork, Ireland (Ms Ryan); and UMC Utrecht Brain Center and Center of Excellence for Rehabilitation Medicine (Dr Verschuren), Utrecht University (Dr van den Hoogen), Utrecht, the Netherlands
| | - Chanel Sam
- Department of Neonatology, Wilhelmina Children's Hospital (Mss de Groot and Sam and Drs Alderliesten, Dudink, and van den Hoogen), and Brain Centre Rudolf Magnus (Drs Alderliesten and Dudink), University Medical Center Utrecht, Utrecht, the Netherlands; INFANT Centre, University College Cork, Cork, Ireland (Ms Ryan); Department of Neonatology, Cork University Maternity Hospital, Cork, Ireland (Ms Ryan); and UMC Utrecht Brain Center and Center of Excellence for Rehabilitation Medicine (Dr Verschuren), Utrecht University (Dr van den Hoogen), Utrecht, the Netherlands
| | - Olaf Verschuren
- Department of Neonatology, Wilhelmina Children's Hospital (Mss de Groot and Sam and Drs Alderliesten, Dudink, and van den Hoogen), and Brain Centre Rudolf Magnus (Drs Alderliesten and Dudink), University Medical Center Utrecht, Utrecht, the Netherlands; INFANT Centre, University College Cork, Cork, Ireland (Ms Ryan); Department of Neonatology, Cork University Maternity Hospital, Cork, Ireland (Ms Ryan); and UMC Utrecht Brain Center and Center of Excellence for Rehabilitation Medicine (Dr Verschuren), Utrecht University (Dr van den Hoogen), Utrecht, the Netherlands
| | - Thomas Alderliesten
- Department of Neonatology, Wilhelmina Children's Hospital (Mss de Groot and Sam and Drs Alderliesten, Dudink, and van den Hoogen), and Brain Centre Rudolf Magnus (Drs Alderliesten and Dudink), University Medical Center Utrecht, Utrecht, the Netherlands; INFANT Centre, University College Cork, Cork, Ireland (Ms Ryan); Department of Neonatology, Cork University Maternity Hospital, Cork, Ireland (Ms Ryan); and UMC Utrecht Brain Center and Center of Excellence for Rehabilitation Medicine (Dr Verschuren), Utrecht University (Dr van den Hoogen), Utrecht, the Netherlands
| | - Jeroen Dudink
- Department of Neonatology, Wilhelmina Children's Hospital (Mss de Groot and Sam and Drs Alderliesten, Dudink, and van den Hoogen), and Brain Centre Rudolf Magnus (Drs Alderliesten and Dudink), University Medical Center Utrecht, Utrecht, the Netherlands; INFANT Centre, University College Cork, Cork, Ireland (Ms Ryan); Department of Neonatology, Cork University Maternity Hospital, Cork, Ireland (Ms Ryan); and UMC Utrecht Brain Center and Center of Excellence for Rehabilitation Medicine (Dr Verschuren), Utrecht University (Dr van den Hoogen), Utrecht, the Netherlands
| | - Agnes van den Hoogen
- Department of Neonatology, Wilhelmina Children's Hospital (Mss de Groot and Sam and Drs Alderliesten, Dudink, and van den Hoogen), and Brain Centre Rudolf Magnus (Drs Alderliesten and Dudink), University Medical Center Utrecht, Utrecht, the Netherlands; INFANT Centre, University College Cork, Cork, Ireland (Ms Ryan); Department of Neonatology, Cork University Maternity Hospital, Cork, Ireland (Ms Ryan); and UMC Utrecht Brain Center and Center of Excellence for Rehabilitation Medicine (Dr Verschuren), Utrecht University (Dr van den Hoogen), Utrecht, the Netherlands
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Benedetto L, Peña F, Rivas M, Ferreira A, Torterolo P. The Integration of the Maternal Care with Sleep During the Postpartum Period. Sleep Med Clin 2023; 18:499-509. [PMID: 38501522 DOI: 10.1016/j.jsmc.2023.06.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/20/2024]
Abstract
Our entire life occurs in a constant alternation between wakefulness and sleep. The impossibility of living without sleep implies that any behavior must adapt to the need for sleep, and maternal behavior does not escape from this determination. Additionally, maternal behavior in mammals is a highly motivated behavior, essential for the survival of the offspring. Thus, the mother has to adapt her physiology of sleep to the constant demands of the pups, where each species will have different strategies to merge these two physiological needs. However, all studied female mammals will experience sleep disturbances at some point of the postpartum period.
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Affiliation(s)
- Luciana Benedetto
- Departamento de Fisiología, Facultad de Medicina, Universidad de la República, Montevideo, Uruguay.
| | - Florencia Peña
- Departamento de Fisiología, Facultad de Medicina, Universidad de la República, Montevideo, Uruguay
| | - Mayda Rivas
- Departamento de Fisiología, Facultad de Medicina, Universidad de la República, Montevideo, Uruguay
| | - Annabel Ferreira
- Sección de Fisiología y Nutrición, Facultad de Ciencias, Universidad de la República, Montevideo, Uruguay
| | - Pablo Torterolo
- Departamento de Fisiología, Facultad de Medicina, Universidad de la República, Montevideo, Uruguay
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15
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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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16
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Begum‐Ali J, Gossé LK, Mason L, Pasco G, Charman T, Johnson MH, Jones EJ. Infant sleep predicts trajectories of social attention and later autism traits. J Child Psychol Psychiatry 2023; 64:1200-1211. [PMID: 36991307 PMCID: PMC10952761 DOI: 10.1111/jcpp.13791] [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] [Accepted: 02/01/2023] [Indexed: 03/31/2023]
Abstract
BACKGROUND Children with neurodevelopmental disorders including autism spectrum disorder (ASD) and attention deficit hyperactivity disorder (ADHD) often experience sleep disturbances, but little is known about when these sleep differences emerge and how they relate to later development. METHODS We used a prospective longitudinal design in infants with a family history of ASD and/or ADHD to examine infant sleep and its relation to trajectories of attention and later neurodevelopmental disorders. We formed factors of Day and Night Sleep from parent-reported measures (including day/night sleep duration, number of naps in the day, frequency of night awakenings and sleep onset problems). We examined sleep in 164 infants at 5-, 10- and 14-months with/without a first-degree relative with ASD and/or ADHD who underwent a consensus clinical assessment for ASD at age 3. RESULTS By 14-months, infants with a first-degree relative with ASD (but not ADHD) showed lower Night Sleep scores than infants with no family history of ASD; lower Night Sleep scores in infancy were also associated with a later ASD diagnosis, decreased cognitive ability, increased ASD symptomatology at 3-years, and developing social attention (e.g., looking to faces). We found no such effects with Day Sleep. CONCLUSIONS Sleep disturbances may be apparent at night from 14-months in infants with a family history of ASD and also those with later ASD, but were not associated with a family history of ADHD. Infant sleep disturbances were also linked to later dimensional variation in cognitive and social skills across the cohort. Night Sleep and Social Attention were interrelated over the first 2 years of life, suggesting that this may be one mechanism through which sleep quality influences neurodevelopment. Interventions targeted towards supporting families with their infant's sleep problems may be useful in this population.
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Affiliation(s)
- Jannath Begum‐Ali
- Department of Psychological Sciences, Centre for Brain and Cognitive DevelopmentBirkbeck, University of LondonLondonUK
| | - Louisa K. Gossé
- Department of Psychological Sciences, Centre for Brain and Cognitive DevelopmentBirkbeck, University of LondonLondonUK
| | - Luke Mason
- Department of Psychological Sciences, Centre for Brain and Cognitive DevelopmentBirkbeck, University of LondonLondonUK
| | - Greg Pasco
- Psychology DepartmentInstitute of Psychiatry, Psychology & Neuroscience, King's College LondonLondonUK
| | - Tony Charman
- Psychology DepartmentInstitute of Psychiatry, Psychology & Neuroscience, King's College LondonLondonUK
| | - Mark H. Johnson
- Department of Psychological Sciences, Centre for Brain and Cognitive DevelopmentBirkbeck, University of LondonLondonUK
- Department of PsychologyUniversity of CambridgeCambridgeUK
| | - Emily J.H. Jones
- Department of Psychological Sciences, Centre for Brain and Cognitive DevelopmentBirkbeck, University of LondonLondonUK
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Gilbert L, Quansah DY, Arhab A, Schenk S, Gross J, Lanzi S, Stuijfzand B, Lacroix A, Horsch A, Puder JJ. Effect of the MySweetheart randomized controlled trial on birth, anthropometric and psychobehavioral outcomes in offspring of women with GDM. Front Endocrinol (Lausanne) 2023; 14:1148426. [PMID: 37351105 PMCID: PMC10284133 DOI: 10.3389/fendo.2023.1148426] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Accepted: 05/22/2023] [Indexed: 06/24/2023] Open
Abstract
Introduction Gestational diabetes mellitus (GDM) may negatively affect offspring outcomes. A lifestyle intervention may therefore not only improve maternal, but also offspring outcomes. The effects of lifestyle interventions on birth, anthropometric, and psychobehavioral outcomes in offspring of women with GDM need further evidence. Design The MySweetheart trial is a monocentric single-blind randomized controlled trial in 211 women with GDM. It tested the effect of a pre- and postpartum multidimensional interdisciplinary lifestyle and psychosocial intervention focusing on both the mothers and their infants and its effects on maternal (primary outcomes) and offspring (secondary outcomes) metabolic and psychobehavioral outcomes compared with guidelines-based usual-care. This paper focuses on offspring's birth, anthropometric, and maternal report of psychobehavioral outcomes at singular timepoints. Methods Women with GDM aged ≥18 years, between 24-32 weeks of gestation, speaking French or English were included and randomly allocated to either the intervention or to an active guidelines-based usual-care group using a 1:1 allocation ratio. The intervention lasted from pregnancy until 1 year postpartum and focused on improving diet, physical activity, and mental health in the mother. For the offspring it focused on supporting breastfeeding, delaying the timing of introduction of solid foods, reducing the consumption of sweetened beverages, increasing physical activity of the family, and improving parental responsiveness to infant distress, hunger, satiety and sleeping cues, and difficult behavior. Results Adverse birth and neonatal outcomes rarely occurred overall. There were no differences between groups in offspring birth, neonatal, anthropometric, or psychobehavioral outcomes up to one year. After adjustments for maternal age and the offspring's sex and age, there was a borderline significant between-group difference in birth length (β:-0.64, CI:-1.27; -0.01, p: 0.05), i.e., offspring of mothers in the intervention group were born 0.64 cm shorter compared to those in the usual-care group. Conclusion This is the first pre- and postpartum multidimensional interdisciplinary lifestyle and psychosocial intervention in GDM focusing on both the mother and the offspring. It did not lead to a significant improvement in most birth, anthropometric, and psychobehavioral outcomes in offspring of women with GDM. ClinicalTrials.gov Identifier: NCT02890693.
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Affiliation(s)
- Leah Gilbert
- Nepean Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
- Obstetric Service, Department Woman-Mother-Child, Interdisciplinary GDM Group Lausanne, Lausanne University Hospital, Lausanne, Switzerland
| | - Dan Yedu Quansah
- Nepean Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Amar Arhab
- Nepean Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Sybille Schenk
- Nepean Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Justine Gross
- Nepean Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Stefano Lanzi
- Service d’angiologie, Département Cœur-Vaisseaux, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland
| | - Bobby Stuijfzand
- Nepean Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Alain Lacroix
- Nepean Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Antje Horsch
- Institute of Higher Education and Research in Healthcare (IUFRS), University of Lausanne, Lausanne, Switzerland
- Neonatology Service, Department Woman-Mother-Child, Lausanne University Hospital, Lausanne, Switzerland
| | - Jardena J. Puder
- Nepean Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
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18
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Rezaei R, Sharifnia H, Nazari R, Saatsaz S. The efficacy of massage as a nightly bedtime routine on infant sleep condition and mother sleep quality: A randomized controlled trial. J Neonatal Perinatal Med 2023:NPM210964. [PMID: 37248915 DOI: 10.3233/npm-210964] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
BACKGROUND AND PURPOSE Infants' sleep disorders and parents' insufficient sleep are common problems in the infant care. The current study was conducted to assess the effectiveness of infant massage on infants' night-time sleep condition and mothers' sleep quality. PROCEDURES 140 infants were randomly put into two different groups, experimental group with fifteen-minute bedtime messages for two weeks and the control group with normal infant routine care. The Brief Infant Sleep Questionnaire, a personal information submission form, and Pittsburgh Sleep Quality Index for the mothers were the tools used to gather data in this study. RESULTS Infants in experimental group showed meaningful differences in variables such as, sleep latency (P < 0001, eta = 0.099), number of night waking (P = 0.03, eta = 0.027) and longest continuous sleep period (P = 0.03, eta = 0.026). As for other variables no meaningful differences were observed. There wasn't meaningful difference in the mother's overall night-time sleep quality between the two groups (P = 0.184, eta = 0.012) except for the duration of the mother's night-time sleep (P = 0.028, eta = 0.026) and the reduction of maternal sleep disorder (P = 0.020 eta = 0.029). CONCLUSION The findings indicated that infants' bedtime massages would improve some of the sleep markers of mothers and infants, and therefore, can be suggested as a practical, harmless, and cost-free method to improve sleep.
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Affiliation(s)
- R Rezaei
- Faculty of Nursing and Midwifery Department of Mazandaran University of Medical Sciences, Sari, Iran
| | - H Sharifnia
- Faculty of Nursing and Midwifery Department of Mazandaran University of Medical Sciences, Sari, Iran
| | - R Nazari
- Faculty of Nursing and Midwifery Department of Mazandaran University of Medical Sciences, Sari, Iran
| | - S Saatsaz
- Faculty of Nursing and Midwifery Department of Mazandaran University of Medical Sciences, Sari, Iran
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曾 繁, 赵 芷, 李 秀, 黎 萍. [Cross-sectional study on the sleep status and risk factors for sleep problems in infants and young children in Jilin Province]. ZHONGGUO DANG DAI ER KE ZA ZHI = CHINESE JOURNAL OF CONTEMPORARY PEDIATRICS 2023; 25:463-469. [PMID: 37272171 PMCID: PMC10247203 DOI: 10.7499/j.issn.1008-8830.2210024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Accepted: 03/16/2023] [Indexed: 06/06/2023]
Abstract
OBJECTIVES To explore the sleep status and risk factors for sleep problems in infants and young children in Jilin Province. METHODS A total of 1 080 healthy infants and young children aged 0-3 years from eight prefecture-level cities and one autonomous prefecture in Jilin Province were selected as subjects. A self-designed questionnaire was used to collect the general information of the subjects, and the Brief Infant Sleep Questionnaire was used to understand the sleep status of the subjects. Multivariate logistic regression analysis was used to analyze the risk factors for sleep problems. RESULTS The total detection rate of sleep problems in the infants and young children was 38.24% (413/1 080). The total sleep time in the 4-11 month, 12-24 month, and 25-36 month age groups was higher than the recommended total sleep time (P<0.05). Multivariate logistic regression analysis showed that full-term birth, higher educational level of the main caregiver, and higher daytime activity intensity were protective factors for sleep problems in the infants and young children (P<0.05), while lower frequency of vitamin D supplementation, frequent night feeding, and maternal snoring were risk factors for sleep problems (P<0.05). CONCLUSIONS The total sleep time of infants and young children over 4 months old in Jilin Province is higher than the recommended total sleep time, but the prevalence rate of sleep problems is higher. The occurrence of sleep problems is related to various factors. Strengthening follow-up on preterm infants, providing education on infant sleep knowledge to primary caregivers, and regularly supplementing with vitamin D can be beneficial in reducing sleep problems in infants and young children.
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Whittall H, Gradisar M, Fitton J, Pillion M, Kahn M. Can cry tolerance be increased in mothers of infants with sleep problems, and why does it matter? A quasi-experimental study. Sleep Med 2023; 107:64-71. [PMID: 37121221 DOI: 10.1016/j.sleep.2023.04.018] [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: 02/24/2023] [Revised: 04/12/2023] [Accepted: 04/13/2023] [Indexed: 05/02/2023]
Abstract
STUDY OBJECTIVES Infant sleep problems are one of the most common complaints of new parents. Research to date has demonstrated a relationship between low parental cry tolerance and infant sleep problems. The aim of this study was to explore whether three emotion regulation strategies could increase parental cry tolerance. METHODS This study utilised a quasi-experimental design. We recruited 83 females (Mage= 32, SD= 5.26) comprising 3 groups: mothers of good sleeping infants aged 6-24 months, mothers of poor sleeping infants aged 6-24 months, and good sleeping women aged 23-40 years without children. Participants were instructed to listen to crying audio segments and indicate when they felt the child needed to be tended to (measured in seconds). This crying audio was paired with one of three emotion-regulation strategies (i.e., music, gaming, reappraisal). Each participant completed all 4 cry conditions which were counterbalanced to control for order effects. RESULTS We found that all three strategies yielded significantly longer reaction times (indicating higher cry tolerance) compared to the control condition (p <.001). We also found that mothers of poor sleepers and good sleeping women benefitted from all three emotion regulation strategies compared to control (p <.001 and p= <.05, respectively). The cry tolerance of mothers of good sleepers, on the other hand, did not differ between the control condition and any of the strategies (all ps >.05). CONCLUSIONS This demonstrates that cry tolerance can be increased using emotion regulation strategies, such as distraction via music or gaming, and reappraisal. This has clinical implications for families implementing behavioural sleep interventions.
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Affiliation(s)
- Hannah Whittall
- Flinders University, College of Education, Psychology and Social Work, Adelaide, South Australia, Australia.
| | | | - Josh Fitton
- Flinders University, College of Education, Psychology and Social Work, Adelaide, South Australia, Australia
| | - Meg Pillion
- Flinders University, College of Education, Psychology and Social Work, Adelaide, South Australia, Australia
| | - Michal Kahn
- Tel Aviv University, School of Psychological Sciences, Israel
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21
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Zhang Z, Matenchuk BA, Skow RJ, Davenport MH, Carson V. Associations between demographic and parental factors and infant sleep characteristics. Sleep Biol Rhythms 2023; 21:221-232. [PMID: 38469278 PMCID: PMC10900024 DOI: 10.1007/s41105-022-00438-w] [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: 06/25/2022] [Accepted: 12/03/2022] [Indexed: 12/23/2022]
Abstract
Although sleep problems are highly prevalent in infants, the intrinsic and extrinsic factors that influence sleep consolidation and regulation in this age group are not well understood. This study aimed to examine the cross-sectional associations of demographic and parental factors with infant sleep characteristics. Participants were 97 Canadian mother-infant dyads primarily from Edmonton, Alberta. Demographic factors (e.g., infant age), parenting practices (e.g., sleep position, sleep initiation methods), and infants sleep characteristics (e.g., the frequency of nighttime awakenings) were assessed using the Brief Infant Sleep Questionnaire. Maternal sleep characteristics (e.g., nighttime sleep duration) were assessed using Actigraph accelerometers. Infant age (mean = 4.24 ± 2.90) was associated with most infant sleep characteristics. In multiple regression models for infant nighttime sleep duration, after removing influential observations, a negative association for side (vs. prone) sleep position was, respectively, observed. In multiple regression models for the frequency of nighttime awakenings in infants, positive associations for infants falling asleep while feeding (vs. in bed alone) and side (vs. prone) sleep position were consistently observed after removing influential observations. Lower nighttime sleep efficiency (B = - 0.08, 95%CI: - 0.13, - 0.02) and longer nighttime wake after sleep onset (B = 1.03, 95%CI: 0.41, 1.65) in mothers were associated with more frequent nighttime awakenings in infants. After removing influential observations, more frequent nighttime awakenings (B = 0.35; 95%CI: 0.09, 0.61) and longer total sleep duration (B = 0.33, 95%CI: 0.11, 0.55) in mothers were also associated with more frequent nighttime awakenings in infants. Sleep initiation methods with less parental involvement, and more continuous and efficient maternal nighttime sleep, tended to be associated with less interrupted infant sleep.
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Affiliation(s)
- Zhiguang Zhang
- Faculty of Kinesiology, Sport and Recreation, University of Alberta, Edmonton, AB T6G 2H9 Canada
| | - Brittany A. Matenchuk
- Program for Pregnancy and Postpartum Health, Physical Activity and Diabetes Laboratory, Faculty of Kinesiology, Sport, and Recreation, Women and Children’s Health Research Institute, Alberta Diabetes Institute, University of Alberta, Edmonton, AB Canada
| | - Rachel J. Skow
- Program for Pregnancy and Postpartum Health, Physical Activity and Diabetes Laboratory, Faculty of Kinesiology, Sport, and Recreation, Women and Children’s Health Research Institute, Alberta Diabetes Institute, University of Alberta, Edmonton, AB Canada
| | - Margie H. Davenport
- Program for Pregnancy and Postpartum Health, Physical Activity and Diabetes Laboratory, Faculty of Kinesiology, Sport, and Recreation, Women and Children’s Health Research Institute, Alberta Diabetes Institute, University of Alberta, Edmonton, AB Canada
| | - Valerie Carson
- Faculty of Kinesiology, Sport and Recreation, University of Alberta, Edmonton, AB T6G 2H9 Canada
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22
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Sırtbaş-Işık G, Yardımcı-Lokmanoğlu BN, Livanelioğlu A, Mutlu A. Sensory processing and sleep characteristics in preterm infants in the early period of life. Sleep Med 2023; 106:78-83. [PMID: 37054558 DOI: 10.1016/j.sleep.2023.03.025] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Revised: 03/09/2023] [Accepted: 03/23/2023] [Indexed: 03/30/2023]
Abstract
OBJECTIVE The present study aimed to investigate the following: (i) differences in sensory processing and sleep characteristics between preterm infants born at < 32 weeks', vs. those born at ≥ 32 weeks' gestation; (ii) differences in sleep characteristics between preterm infants with typical vs. atypical sensory processing; and (iii) relationship between sensory processing and sleep characteristics in preterm infants at 3 months of age. METHODS A total of 189 preterm infants, 54 born at < 32 weeks' gestation (26 females; mean gestational age [standard deviation (SD)], 30.1 [1.7] weeks), and 135 born at ≥ 32 weeks' gestation (78 females; mean gestational age [SD], 34.9 [0.9] weeks) were included in the present study. Sleep characteristics were evaluated using the Brief Infant Sleep Questionnaire, and sensory processing was assessed using the Infant Sensory Profile-2. RESULTS There were no significant differences in sensory processing (P > 0.05) or sleep characteristics (P > 0.05) between the preterm groups; however, more infants snored in the <32 weeks' gestation group (P = 0.035). Preterm infants with atypical sensory processing showed lower nighttime (P = 0.027) and total sleep durations (P = 0.032), and higher rates of nocturnal wakefulness (P = 0.038) and snoring (P = 0.001) than preterm infants with typical sensory processing. A significant relationship, therefore, was observed between sensory processing and sleep characteristics (P < 0.05). CONCLUSIONS Sensory processing patterns may play an important role in understanding sleep problems in preterm infants. The early detection of sleep problems and sensory processing difficulties are necessary for early intervention.
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23
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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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24
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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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25
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Armstrong B, Weaver RG, Beets MW, Østbye T, Kravitz RM, Benjamin-Neelon SE. Use of Child Care Attenuates the Link Between Decreased Maternal Sleep and Increased Depressive Symptoms. J Dev Behav Pediatr 2022; 43:e330-e338. [PMID: 35075045 PMCID: PMC9177505 DOI: 10.1097/dbp.0000000000001048] [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: 06/01/2021] [Accepted: 10/12/2021] [Indexed: 01/26/2023]
Abstract
OBJECTIVE Sleep disruption is common among postpartum women and is linked with depression. Child care may alleviate parenting stress and protect new mothers against symptoms of depression. METHODS Mothers from the NURTURE study, a birth cohort of 666 women of full-term infants, completed questionnaires during home visits when their infants were 3, 6, 9, and 12 months old. The Edinburgh Postnatal Depression Scale and the Perceived Stress Scale were used to measure depressive symptoms and stress, respectively. Mothers reported total nightly sleep duration for themselves and their infants, child care arrangements, marital status, and income. We used mixed-effects models adjusting for income, marital status, and child age to examine the indirect effect of infants' sleep on maternal mental health through mothers' sleep and assessed whether patterns differed depending on child care. RESULTS Decreased maternal sleep mediated the association between infant sleep and maternal mental health. When infants slept 1 hour less than usual, mothers slept 7 fewer minutes (B = 0.19, 95% confidence interval [CI], 0.01 to 0.27) and reported more depressive symptoms (B = -0.27, 95% CI, -0.43 to -0.11) and stress (B = -0.33, 95% CI -0.58 to -0.09). Child care moderated the indirect effect; decreased maternal sleep was not associated with increased depressive symptoms (and was not a mediator) when mothers had child care (indirect effect = -0.001, 95% CI, -0.03 to 0.03). CONCLUSION Use of infant child care reduced the link between maternal sleep and depressive symptoms. Regular access to child care may be a method to mitigate feelings of depression for new mothers.
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Affiliation(s)
- Bridget Armstrong
- University of South Carolina, Department of Exercise
Science, Columbia, South Carolina, USA
| | - R. Glenn Weaver
- University of South Carolina, Department of Exercise
Science, Columbia, South Carolina, USA
| | - Michael W. Beets
- University of South Carolina, Department of Exercise
Science, Columbia, South Carolina, USA
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26
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Yang YT, Zou JJ, Wei Q, Shi YY, Zhang YH, Shi HJ. A Longitudinal Study of the Effects of Bed-Sharing Experience in Infancy on Sleep Outcomes at 2 Years Old. J Pediatr 2022; 245:142-148.e2. [PMID: 35120991 DOI: 10.1016/j.jpeds.2022.01.045] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 12/29/2021] [Accepted: 01/26/2022] [Indexed: 11/19/2022]
Abstract
OBJECTIVE To assess the effects of bed-sharing experiences in infancy on sleep patterns and sleep problems at 2 years of age. STUDY DESIGN A total of 1564 children from an ongoing Shanghai Maternal-Child Pairs Cohort were included. Bed-sharing experiences were collected when children were 2, 6, and 24 months old via caregiver-completed questionnaires (whether caregivers shared a bed with children during the night), and children's bed-sharing experiences were classified as follows: no bed-sharing, early-only bed-sharing, late-onset bed-sharing, and persistent bed-sharing. Sleep outcomes at month 24 were assessed using the Brief Infant Sleep Questionnaire. Sleep patterns and problems were compared among the 4 types of bed-sharing experiences. RESULTS Of the 1564 infants, 10.10% had no bed-sharing, 18.35% had early-only, 27.94% had late-onset, and 43.61% had persistent bed-sharing. Compared with children with no bed-sharing, children with late-onset and persistent bed-sharing had shorter nighttime sleep durations and longer daytime sleep durations (P < .05) and were more likely to snore (aOR 1.87 [95% CI 1.25-2.79]; aOR 1.68 [95% CI 1.14-2.47]) and have sleep onset difficulty (aOR 2.06 [95% CI 1.37-3.09]; aOR 2.07 [95% CI 1.41-3.05]). However, caregivers of infants in the late-onset and persistent bed-sharing groups perceived less problematic sleep (aOR 0.38 [95% CI 0.26-0.56] and aOR 0.40 [95% CI 0.28-0.58]). CONCLUSIONS Bed-sharing is a common experience among Chinese children. Although bed-sharing may reduce caregivers' perception of children's problematic sleep, late-onset or persistent bed-sharing in infancy is associated with sleep problems at 2 years of age.
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Affiliation(s)
- Yan-Ting Yang
- Key Laboratory of Public Health Safety, Ministry of Education, School of Public Health, Fudan University, Shanghai, China
| | - Jiao-Jiao Zou
- Key Laboratory of Public Health Safety, Ministry of Education, School of Public Health, Fudan University, Shanghai, China
| | - Qian Wei
- Key Laboratory of Public Health Safety, Ministry of Education, School of Public Health, Fudan University, Shanghai, China
| | - Yu-Yang Shi
- Key Laboratory of Public Health Safety, Ministry of Education, School of Public Health, Fudan University, Shanghai, China
| | - Yun-Hui Zhang
- Key Laboratory of Public Health Safety, Ministry of Education, School of Public Health, Fudan University, Shanghai, China
| | - Hui-Jing Shi
- Key Laboratory of Public Health Safety, Ministry of Education, School of Public Health, Fudan University, Shanghai, China.
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27
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Pecora G, Focaroli V, Paoletti M, Barca L, Chiarotti F, Borghi AM, Gasparini C, Caravale B, Bombaci I, Gastaldi S, Bellagamba F, Addessi E. Infant sleep and development: Concurrent and longitudinal relations during the first 8 months of life. Infant Behav Dev 2022; 67:101719. [DOI: 10.1016/j.infbeh.2022.101719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Revised: 03/25/2022] [Accepted: 04/12/2022] [Indexed: 11/05/2022]
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28
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Hernandez-Reif M, Gungordu N. Infant sleep behaviors relate to their later cognitive and language abilities and morning cortisol stress hormone levels. Infant Behav Dev 2022; 67:101700. [DOI: 10.1016/j.infbeh.2022.101700] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Revised: 01/06/2022] [Accepted: 02/02/2022] [Indexed: 11/30/2022]
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29
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Tange A, Hayashi M. The Use of Caregivers’ Smartphones to Assist Infants’ Circadian Sleep–Wake Cycles. Percept Mot Skills 2022; 129:415-430. [DOI: 10.1177/00315125221088531] [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]
Abstract
Parents and caregivers lack knowledge regarding young children’s sleep routines due to an absence of general guidelines about sleep development, and this knowledge gap has been associated with infants’ sleep problems. Approximately 30% of infants develop sleep problems, including difficulty with falling asleep and night-waking. In this study, we sought to develop a new indicator of regularity in infants’ circadian sleep–wake patterns. Our participants were healthy Japanese mothers and their infants ( n = 172 infants; Mage = 4.9, SD = 3.5 months). Mothers used their smartphones to record the time when their infants fell asleep and woke up in their natural home environments over 7 days. We conducted least-squares spectrum analysis, a time-series analysis often used in chronobiology, to calculate the percentage variance (PVA) of the best-fitted cosine waves with a 24-hr periodicity in the infants’ sleep records. We found that the PVA of the 24-hr cycles in the infants’ sleep records were significantly correlated with the infants’ age in months ( r = 0.554, p < 0.001), variations in their waking-up ( r = −0.316, p < 0.001) and falling asleep times ( r = −0.430, p < 0.001), and sleep duration ( r = −0.343, p < 0.001). Apart from these normative data, which are of potential comparative use by other investigators, we showed in this study that PVA data can be collected by infants’ parents and caretakers through smartphones to provide parents an indicator of the regularity of an infant’s 24-hr periodicity.
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Affiliation(s)
- Akiko Tange
- Unicharm Corporation, Kagawa Prefecture, Japan
- Graduate School of Integrated arts and Sciences, Hiroshima University, Higashihiroshima, Japan
| | - Mitsuo Hayashi
- Graduate School of Humanities and Social Sciences, Hiroshima University, Higashihiroshima, Japan
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30
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Pavkovic IM, Kothare SV. Pharmacologic Approaches to Insomnia and Other Sleep Disorders in Children. Curr Treat Options Neurol 2022. [DOI: 10.1007/s11940-022-00712-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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31
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Association of maternal prenatal depression and anxiety with toddler sleep: the China-Anhui Birth Cohort study. Arch Womens Ment Health 2022; 25:431-439. [PMID: 34997848 DOI: 10.1007/s00737-021-01200-w] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Accepted: 12/26/2021] [Indexed: 12/24/2022]
Abstract
Maternal prenatal depression is associated with child sleep. We investigated whether maternal depression comorbid with anxiety worsens toddler's sleep problems in a prospective cohort study. A total of 1583 mother-infant pairs from the China-Anhui Birth Cohort study were examined. The participants completed the Center for Epidemiologic Studies Depression Scale (CES-D) and Self-Rating Anxiety Scale (SAS) at 30-34 weeks of gestation, and the Edinburgh Postnatal Depression Scale (EPDS) at 3-month postpartum. Toddler's sleep was assessed by the Brief Infant Sleep Questionnaire (BISQ) at 30 months old. Logistic regression models were used to investigate the associations between prenatal depression and anxiety and toddler's sleep, while adjusting for maternal gestational age, education, family income, alcohol use, premature birth, fetal growth restriction, mode of delivery, postnatal depression, and 3-month breastfeeding. In total, 9.0% of participants reported prenatal depression comorbid with anxiety symptoms, and the prevalence of depression, anxiety was 6.7% and 7.3%, respectively. Compared with mothers without depression and anxiety, maternal depression combined with anxiety were significantly associated with shorter total sleep duration (11.16 ± 1.06 h), longer settling time (29.25 ± 23.57 min), and higher risk of toddlers' sleep problems assessed by BISQ (OR = 2.09, 95% CI: 1.22-3.57) or parental report (OR = 1.84, 95% CI: 1.22-2.77). However, there was no significant association between maternal postnatal depression and toddler sleep behaviors. Maternal prenatal depression comorbid with anxiety significantly associated with poorer toddler's sleep. Strategies to regulate prenatal mood status should be considered during prenatal health care to improve children's sleep development.
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32
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Quante M, McGee GW, Yu X, von Ash T, Luo M, Kaplan ER, Rueschman M, Haneuse S, Davison KK, Redline S, Taveras EM. Associations of sleep-related behaviors and the sleep environment at infant age one month with sleep patterns in infants five months later. Sleep Med 2022; 94:31-37. [DOI: 10.1016/j.sleep.2022.03.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Revised: 03/09/2022] [Accepted: 03/23/2022] [Indexed: 10/18/2022]
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33
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Lobermeier M, Staples AD, Peterson C, Huth-Bocks AC, Warschausky S, Taylor HG, Brooks J, Lukomski A, Lajiness-O'Neill R. Cumulative risk, infant sleep, and infant social-emotional development. Infant Behav Dev 2022; 67:101713. [PMID: 35339929 PMCID: PMC9526438 DOI: 10.1016/j.infbeh.2022.101713] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2021] [Revised: 03/12/2022] [Accepted: 03/15/2022] [Indexed: 11/17/2022]
Abstract
The effect of cumulative biological, psychosocial, and demographic risk and infant sleep on infant social-emotional functioning in 12-month-old infants (46% female) was examined in data from racially (30% Black, 60% White, 10% multiracial/other) and socioeconomically (41% below median income) diverse caregivers (N = 468, M = 30.42 years old, SD = 5.65) recruited from two midwestern states in 2019-2020. Due to the major changes in sleep patterns during infancy and the reported association between sleep and social-emotional functioning, this study also examined whether sleep moderates the association between risk and infant social-emotional functioning and potentially promotes healthy social-emotional functioning despite risk. Greater cumulative risk was associated with poorer sleep efficiency and more social-emotional problems, but was not associated with the general acquisition of social-emotional milestones. Results also suggested that poorer sleep efficiency was associated with more social-emotional problems and poorer social-emotional milestone acquisition. No significant interaction effects were found between cumulative risk and infant sleep. Risk and sleep appear to have unique associations with infant social-emotional problems and development; thus both could be targeted in early intervention to promote social-emotional functioning during infancy and early childhood.
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Affiliation(s)
| | - Angela D Staples
- Eastern Michigan University, Department of Psychology, Ypsilanti, MI, USA
| | - Catherine Peterson
- Eastern Michigan University, Department of Psychology, Ypsilanti, MI, USA
| | - Alissa C Huth-Bocks
- University Hospitals Cleveland Medical Center, Pediatrics, Cleveland, OH, USA; Case Western Reserve University and Rainbow Babies & Children's Hospital, Department of Pediatrics, Cleveland, Ohio, USA
| | - Seth Warschausky
- University of Michigan, Michigan Medicine, Department of Physical Medicine and Rehabilitation, Ann Arbor, Michigan, USA
| | - H Gerry Taylor
- Case Western Reserve University and Rainbow Babies & Children's Hospital, Department of Pediatrics, Cleveland, Ohio, USA; Nationwide Children's Hospital Research Institute and The Ohio State University, Department of Pediatrics, Columbus, Ohio, USA
| | - Judith Brooks
- Eastern Michigan University, School of Health Sciences, Dietetics and Human Nutrition Programs, Ypsilanti, MI, USA
| | - Angela Lukomski
- Eastern Michigan University, School of Nursing, Ypsilanti, Michigan, USA
| | - Renée Lajiness-O'Neill
- Eastern Michigan University, Department of Psychology, Ypsilanti, MI, USA; University of Michigan, Michigan Medicine, Department of Physical Medicine and Rehabilitation, Ann Arbor, Michigan, USA.
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34
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Infant sleep and negative reactivity: The role of maternal adversity and perinatal sleep. Infant Behav Dev 2022; 66:101664. [PMID: 34958975 PMCID: PMC9162035 DOI: 10.1016/j.infbeh.2021.101664] [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: 05/25/2021] [Revised: 10/02/2021] [Accepted: 11/07/2021] [Indexed: 02/03/2023]
Abstract
Sleep during infancy contributes to the development and maintenance of infant regulatory functioning and may be an early risk marker for more difficult temperamental traits like negative reactivity. Further, maternal adverse childhood experiences (ACEs) may predispose individuals to greater sleep disturbances in adulthood and have been linked with sleep disturbances in both mothers and infants. Thus, examining maternal history of ACEs and maternal sleep difficulties during pregnancy and postpartum may provide insight into underlying risk factors affecting infant sleep difficulties and early temperament development. Fifty-nine mothers from a diverse, community sample (44% white) completed questionnaires on ACEs, maternal sleep, infant sleep, and infant temperament at 30-weeks gestation, 6-weeks postpartum, and 16-weeks postpartum. Results indicated that maternal ACES and sleep problems during pregnancy have long term implications for infant negative reactivity at 16-weeks, with significant indirect effects through maternal and infant sleep problems at 6-weeks. Addressing psychosocial functioning and prenatal sleep during pregnancy, particularly among women with high ACEs, may be a target of intervention to improve maternal and infant sleep health during the postpartum, and reduce the risk for difficult infant temperament.
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35
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Wang Y, van de Wouw M, Drogos L, Vaghef-Mehrabani E, Reimer RA, Tomfohr-Madsen L, Giesbrecht GF. Sleep and the gut microbiota in preschool-aged children. Sleep 2022; 45:6509073. [PMID: 35037059 PMCID: PMC9189981 DOI: 10.1093/sleep/zsac020] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 12/24/2021] [Indexed: 01/19/2023] Open
Abstract
Sleep plays a significant role in the mental and physical development of children. Emerging evidence in animals and human adults indicates a relationship between sleep and the gut microbiota; however, it is unclear whether the sleep of preschoolers during a key developmental period, associates with features of their gut microbiota. The objective of this study was to assess the relationship between sleep and gut microbiota in preschool-aged children (4.37 ± 0.48 years, n = 143). Sleep measures included total night-time sleep (TST), sleep efficiency (SE), and wake-time after sleep onset (WASO) assessed using actigraphy. Beta-diversity differences between children with low and high TST (p = .048) suggest gut microbiota community differences. Particularly, relative abundance of Bifidobacterium was higher in the high TST group and Bacteroides, was higher in children who had greater SE and less WASO (LDA score >2). In contrast, some Lachnospiraceae members including Blautia and Coprococcus 1 were associated with shorter night-time sleep duration and less efficiency, respectively. We also found a group of fecal metabolites, including specific neuroactive compounds and immunomodulating metabolites were associated with greater sleep efficiency and less time awake at night. Notably, tryptophan and its metabolizing products were higher in children who had higher SE or lower WASO (LDA score >2); concentration of propionate was higher in children with less WASO (p = .036). Overall, our results reveal a novel association between sleep and gut microbiota in preschool-aged children. Longer night-time sleep and greater sleep efficiency were associated with specific commensal bacteria that may regulate sleep through modulating neurotransmitter metabolism and the immune system.
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Affiliation(s)
- Yanan Wang
- Department of Pediatrics, University of Calgary, Calgary, AB, Canada
| | | | - Lauren Drogos
- Department of Psychology, University of Calgary, Calgary, AB, Canada,Libin Cardiovascular Institute, University of Calgary, Calgary, AB, Canada
| | | | - Raylene A Reimer
- Alberta Children’s Hospital Research Institute (ACHRI), Calgary, AB, Canada,Faculty of Kinesiology, University of Calgary, Calgary, AB, Canada,Department of Biochemistry and Molecular Biology, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Lianne Tomfohr-Madsen
- Department of Pediatrics, University of Calgary, Calgary, AB, Canada,Department of Psychology, University of Calgary, Calgary, AB, Canada,Department of Community Health Sciences, University of Calgary, Calgary, AB, Canada
| | - Gerald F Giesbrecht
- Corresponding author. Gerry Giesbrecht, Department of Psychology, University of Calgary, 2500 University Drive, NW, Calgary, AB, T2N 1N4, Canada.
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The impact of reducing the frequency of night feeding on infant BMI. Pediatr Res 2022; 91:254-260. [PMID: 33664477 PMCID: PMC8604149 DOI: 10.1038/s41390-021-01397-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Revised: 12/23/2020] [Accepted: 01/06/2021] [Indexed: 11/20/2022]
Abstract
BACKGROUND Teaching caregivers to respond to normal infant night awakenings in ways other than feeding is a common obesity prevention effort. Models can simulate caregiver feeding behavior while controlling for variables that are difficult to manipulate or measure in real life. METHODS We developed a virtual infant model representing an infant with an embedded metabolism and his/her daily sleep, awakenings, and feeds from their caregiver each day as the infant aged from 6 to 12 months (recommended age to introduce solids). We then simulated different night feeding interventions and their impact on infant body mass index (BMI). RESULTS Reducing the likelihood of feeding during normal night wakings from 79% to 50% to 10% lowered infant BMI from the 84th to the 75th to the 62nd percentile by 12 months, respectively, among caregivers who did not adaptively feed (e.g., adjust portion sizes of solid foods with infant growth). Among caregivers who adaptively feed, all scenarios resulted in relatively stable BMI percentiles, and progressively reducing feeding probability by 10% each month showed the least fluctuations. CONCLUSIONS Reducing night feeding has the potential to impact infant BMI, (e.g., 10% lower probability can reduce BMI by 20 percentile points) especially among caregivers who do not adaptively feed. IMPACT Teaching caregivers to respond to infant night waking with other soothing behaviors besides feeding has the potential to reduce infant BMI. When reducing the likelihood of feeding during night wakings from 79% to 50% to 10%, infants dropped from the 84th BMI percentile to the 75th to the 62nd by 12 months, respectively, among caregivers who do not adaptively feed. Night-feeding interventions have a greater impact when caregivers do not adaptively feed their infant based on their growth compared to caregivers who do adaptively feed. Night-feeding interventions should be one of the several tools in a multi-component intervention for childhood obesity prevention.
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37
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Blunden S, Osborne J, King Y. Do responsive sleep interventions impact mental health in mother/infant dyads compared to extinction interventions? A pilot study. Arch Womens Ment Health 2022; 25:621-631. [PMID: 35380237 PMCID: PMC9072263 DOI: 10.1007/s00737-022-01224-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2022] [Accepted: 03/15/2022] [Indexed: 11/30/2022]
Abstract
Methods to improve sleep in infants commonly involve some ignoring (extinction) but are often unpopular with mothers worried about infant distress when left to cry. Alternative more responsive methods are needed. This pilot study evaluated stress, maternal depressive symptomology and sleep in mother/infant dyads, between Responsive, Controlled Crying and Control groups. From 199 mother/infant dyads from any cultural background, 41 infants 4-12 months were randomly allocated to Responsive (RG, n = 15), Controlled Crying (CCG, n = 18) or Controls (Treatment as Usual, TAUG, n = 8), with 10 withdrawing after randomisation. Infant sleep (7-day sleep diaries) and stress (oral cortisol on two nights), maternal self-reported stress (Subjective Units of Distress, SUDS), maternal perceived infant distress (MPI-S) and symptoms of maternal depression (Edinburgh Post-natal Depression Scale, EPDS) were measured four times across 8 weeks. Sleep duration was not different between groups but Responsive woke less (p = .008). There were no differences in cortisol between groups across time points. Maternal SUDS was positively correlated with infant cortisol and MPI-S (p < 0.05) and mothers in the Responsive group were significantly less stressed (p = 0.02) and reported less symptoms of depression (p < 0.05). Findings in this small sample show Responsive methods are comparable to the extinction (Controlled Crying) in sleep outcomes but from a relational and maternal mental health perspective, are less stressful, offering families potential choices of sleep interventions.
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Affiliation(s)
- Sarah Blunden
- Appleton Institute, Central Queensland University, 44 Greenhill Rd, South Australia, Wayville, 5034, Australia.
| | - Joanne Osborne
- Appleton Institute, Central Queensland University, 44 Greenhill Rd, South Australia Wayville, 5034 Australia
| | - Yaroslava King
- Appleton Institute, Central Queensland University, 44 Greenhill Rd, South Australia Wayville, 5034 Australia
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38
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Jin M, Kato M, Itakura S. Development of a classifier to screen for severe sleep disorders in children. Front Pediatr 2022; 10:902012. [PMID: 35935356 PMCID: PMC9354400 DOI: 10.3389/fped.2022.902012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Accepted: 06/27/2022] [Indexed: 11/13/2022] Open
Abstract
This study aimed to develop an automatic classifier for the identification of severe sleep disorders that require immediate intervention in children. Our study assessed 7,008 children (age: 0-83 months) in Japan, whose parents and nursery teachers recorded their 14-day sleep patterns. Sleep quality was assessed by pediatricians and scored as 1 (no severe sleep disorder) or 0 (severe sleep disorder). Discriminant analysis was performed for each age group using sleep quality (0 or 1) as the dependent variable and variables in the 14-day sleep log as independent variables. A stepwise method was used to select the independent variables to build the best model. The accuracy of the discriminant analysis for the age groups ranged from 71.3 to 97.3%. In summary, we developed an automatic classifier with sufficient application value to screen for severe sleep disorders in children. In the future, this classifier can be used to rapidly determine the presence or absence of severe sleep disorders in children based on their 14-day sleep logs, thus allowing immediate intervention.
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Affiliation(s)
- Mingwen Jin
- Center for Baby Science, Doshisha University, Kyoto, Japan
| | - Masaharu Kato
- Center for Baby Science, Doshisha University, Kyoto, Japan
| | - Shoji Itakura
- Center for Baby Science, Doshisha University, Kyoto, Japan
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Bucko AG, Dowda M, Frongillo EA, Torres ME, Pate RR. Nighttime sleep and physical activity in 6-7 month-old infants. Infant Behav Dev 2021; 65:101628. [PMID: 34392076 PMCID: PMC8627435 DOI: 10.1016/j.infbeh.2021.101628] [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: 03/22/2021] [Revised: 08/05/2021] [Accepted: 08/06/2021] [Indexed: 11/16/2022]
Abstract
This study examined associations between objectively-measured nighttime sleep duration and physical activity in a sample of 6-7 month-old infants (N=93). The study also investigated relationships between infant sleep and demographic and environmental characteristics. Cross-sectional relationships were assessed using linear regression analyses. Nighttime sleep duration was positively associated with physical activity levels. Nighttime sleep duration was greater when infants had a consistent bedtime, slept in a separate room, were male, and had mothers who reported having a college education or greater. These findings can inform the development of interventions that aim to improve infant sleep.
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Affiliation(s)
- Agnes G Bucko
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States.
| | - Marsha Dowda
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States
| | - Edward A Frongillo
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States
| | - Myriam E Torres
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States
| | - Russell R Pate
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States
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40
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Witte AM, de Moor MHM, Szepsenwol O, van IJzendoorn MH, Bakermans-Kranenburg MJ, Shai D. Developmental trajectories of infant nighttime awakenings are associated with infant-mother and infant-father attachment security. Infant Behav Dev 2021; 65:101653. [PMID: 34655886 DOI: 10.1016/j.infbeh.2021.101653] [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: 06/07/2021] [Revised: 10/04/2021] [Accepted: 10/04/2021] [Indexed: 11/26/2022]
Abstract
This longitudinal study examined developmental trajectories of infant sleep problems from 3 to 24 months old and investigated associations with infant-parent attachment security and dependency. In a sample of 107 Israeli families, number and duration of infant nighttime awakenings were measured at 3, 6, 9, and 24 months old, using mothers' and fathers' reports on the Brief Infant Sleep Questionnaire (BISQ). Infant-parent attachment security and infant-parent dependency was assessed at 24 months old, using the observer Attachment Q-Sort procedure (AQS) with both parents. Latent growth curve models showed a non-linear decline in number and duration of infant nighttime awakenings over time. A higher number and longer duration of infant nighttime awakenings at 3 months were associated with higher infant-father attachment security at 24 months. In contrast, longer infant nighttime awakenings at 3 months were predictive of lower infant-mother attachment security at 24 months. A steeper decrease in duration of infant nighttime awakenings was associated with higher infant-father attachment security and lower infant-mother attachment security. As a potential mechanism, paternal involvement in nighttime caregiving was explored in relation to infant-father attachment security. Results of our post-hoc analyses revealed no significant associations between paternal involvement in nighttime caregiving and infant-father attachment security. Our results highlight the need to examine potential mechanisms explaining the divergent associations of infant sleep problems with infant-mother and infant-father attachment security in future research.
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Affiliation(s)
- Annemieke M Witte
- Clinical Child & Family Studies, Faculty of Behavioral and Movement Sciences, Vrije Universiteit, Amsterdam, the Netherlands.
| | - Marleen H M de Moor
- Clinical Child & Family Studies, Faculty of Behavioral and Movement Sciences, Vrije Universiteit, Amsterdam, the Netherlands
| | - Ohad Szepsenwol
- Department of Education, The Max Stern Yezreel Valley College, Israel
| | - Marinus H van IJzendoorn
- Department of Psychology, Education, and Child Studies, Erasmus University Rotterdam, Rotterdam, the Netherlands
| | - Marian J Bakermans-Kranenburg
- Clinical Child & Family Studies, Faculty of Behavioral and Movement Sciences, Vrije Universiteit, Amsterdam, the Netherlands; Leiden Institute for Brain and Cognition, Leiden University Medical Center, Leiden, the Netherlands
| | - Dana Shai
- SEED Center, School of Behavior Sciences, Academic College Tel Aviv-Yaffo, Israel
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41
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MacKinnon AL, Tomfohr-Madsen L, Tough S. Neighborhood Socio-Economic Factors and Associations with Infant Sleep Health. Behav Sleep Med 2021; 19:458-470. [PMID: 32571082 DOI: 10.1080/15402002.2020.1778478] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
UNLABELLED Background: Sleep health is important for development and improves overall health. There are large socioeconomic gradients in sleep health, from childhood through adulthood. Recent findings suggest that children from neighborhoods with poorer socioeconomic conditions have more sleep problems. The current study aimed to investigate the associations between neighborhood factors and infant sleep health. PARTICIPANTS AND METHODS Secondary data analysis using Multilevel Modeling (MLM) was conducted for a subsample of 2445 women from the All our Families longitudinal cohort study, for whom early pregnancy neighborhood data could be geocoded. The Vancouver Area Neighborhood Deprivation Index (VANDIX) was calculated using census data to assess neighborhood SES. Neighborhood disorder was measured using community crime reports from police services. Mothers rated the perceived safety of their neighborhood and reported on their infants' nighttime sleep consolidation, awakenings, and onset latency at 12 months postpartum. RESULTS MLM indicated that neighborhood disorder and maternal perceptions of unsafety predicted less consolidated sleep after accounting for individual and family-level factors including maternal ethnicity, household income, breastfeeding duration, and co-sleeping. Neighborhood deprivation was indirectly related to less consolidated sleep among 12-month-old infants through more reports of disorder and maternal perceptions of less safety. CONCLUSIONS Consistent with the socio-ecological model of sleep, neighborhood-level, family, and individual factors influence infant sleep health. Policy efforts to increase neighborhood safety and public health initiatives to increase awareness of the importance of sleep could help improve infant sleep health.
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Affiliation(s)
- Anna L MacKinnon
- Community Health Sciences, University of Calgary, Calgary, Alberta, Canada.,Department of Psychology, University of Calgary
| | - Lianne Tomfohr-Madsen
- Department of Psychology, University of Calgary.,Alberta Children's Hospital Research Institute.,Department of Pediatrics, University of Calgary, Calgary, Canada
| | - Suzanne Tough
- Community Health Sciences, University of Calgary, Calgary, Alberta, Canada.,Department of Pediatrics, University of Calgary, Calgary, Canada
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42
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Emond JA, O'Malley AJ, Neelon B, Kravitz RM, Ostbye T, Benjamin-Neelon SE. Associations between daily screen time and sleep in a racially and socioeconomically diverse sample of US infants: a prospective cohort study. BMJ Open 2021; 11:e044525. [PMID: 34168024 PMCID: PMC8231048 DOI: 10.1136/bmjopen-2020-044525] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
OBJECTIVE To determine the associations between screen media use and sleep throughout infancy (3-12 months). DESIGN Prospective Nurture birth cohort. SETTING North Carolina, USA, 2013-2015. PARTICIPANTS Women enrolled in their second to third trimester, completed a phone interview after birth, and completed home visits at 3, 6, 9 and 12 months post partum. PRIMARY AND SECONDARY OUTCOME MEASURES Women reported the usual hours their infants slept during the day and night and their infants' usual use of five screen media activities at 3, 6, 9 and 12 months post partum. Adjusted mixed-effects regression analyses modelled the associations between infant screen time and sleep outcomes while disaggregating the between-infant and within-infant effects. RESULTS Among 558 mother-infant dyads, 374 (67.0%) infants were black and 304 (54.5%) households earned <$20 000 per year. Half (254, 50.2%) of the infants engaged with screens at 3 months of age, while 326 (72.9%) engaged at 12 months. The median value of the average daily screen time over the study period was 50 (IQR: 10-141) min. Infant screen time was inversely associated with night-time sleep duration only when considering between-infant effects (adjusted beta: -2.9; 95% CI -5.9 to 0.0; p=0.054 for log-transformed screen time). Effects were stronger for television+DVD viewing specifically (adjusted beta: -5.2; 95% CI -9.1 to -1.4; p<0.01 for log-transformed television+DVD time). For example, an infant who averaged 1 hour of television+DVD viewing over the study period slept, on average, 9.20 (95% CI 9.02 to 9.37) hours per night by 12 months compared with 9.60 (95% CI 9.41 to 9.80) hours per night for an infant with no screen time over the study period. There were no significant within-infant effects between screen time and night-time sleep, and screen time was not associated with daytime sleep or night-time awakenings. CONCLUSIONS Screen time during infancy was inversely associated with night-time sleep duration; however, causal associations remain uncertain. TRIAL REGISTRATION NUMBER NCT01788644.
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Affiliation(s)
- Jennifer A Emond
- Department of Biomedical Data Science, Geisel School of Medicine, Dartmouth College, Hanover, New Hampshire, USA
- Department of Pediatrics, Geisel School of Medicine, Dartmouth College, Hanover, New Hampshire, USA
| | - A James O'Malley
- Department of Biomedical Data Science, Geisel School of Medicine, Dartmouth College, Hanover, New Hampshire, USA
- The Dartmouth Institute, Geisel School of Medicine, Dartmouth College, Hanover, New Hampshire, USA
| | - Brian Neelon
- Department of Public Health Sciences, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Richard M Kravitz
- Division of Pediatric Pulmonary and Sleep Medicine, Duke University Medical Center, Durham, North Carolina, USA
| | - Truls Ostbye
- Department of Family Medicine and Community Health, Duke University, Durham, North Carolina, USA
| | - Sara E Benjamin-Neelon
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
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43
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Kahn M, Livne-Karp E, Juda-Hanael M, Omer H, Tikotzky L, Anders TF, Sadeh A. Behavioral interventions for infant sleep problems: the role of parental cry tolerance and sleep-related cognitions. J Clin Sleep Med 2021; 16:1275-1283. [PMID: 32279703 DOI: 10.5664/jcsm.8488] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
STUDY OBJECTIVES This study tested whether parental cry tolerance (PCT) and distress-attribution cognitions predict outcomes of behavioral interventions for infant sleep problems. It additionally examined intervention effects on these parental factors. METHODS Participants were 91 infants aged 9-18 months (61% boys) with sleep-related problems and their parents. Families were randomized to 1 of 2 behavioral interventions for infant sleep problems: Checking-in or Camping-out. Assessments were completed at baseline and 1-month post-treatment. Infant sleep was assessed using actigraphy and parent reports on the Brief Infant Sleep Questionnaire. PCT was measured using the Intervention Delay to Infant Crying Video laboratory paradigm, and parental distress-attribution cognitions were assessed via the Infant Sleep Vignettes Interpretation Scale. RESULTS Higher PCT and lower parental distress-attribution cognitions at baseline predicted greater improvement in parent-reported sleep problems post-treatment, and higher PCT additionally predicted larger reductions in the number of reported nighttime awakenings. Moreover, PCT increased, and distress-attribution decreased, following the interventions. CONCLUSIONS Parent factors both predict and are predicted by behavioral interventions for infant sleep problems. This study's findings suggest that parents with low cry tolerance and high distress-attribution cognitions derive less benefit from these interventions and may thus require augmented care. CLINICAL TRIAL REGISTRATION Registry: ClinicalTrials.gov; Name: Interventions for sleep problems in early childhood; URL: https://clinicaltrials.gov/ct2/show/NCT01489215;Identifier: NCT01489215.
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Affiliation(s)
- Michal Kahn
- School of Psychological Sciences, Tel Aviv University, Tel-Aviv, Israel
| | - Efrat Livne-Karp
- School of Psychological Sciences, Tel Aviv University, Tel-Aviv, Israel
| | | | - Haim Omer
- School of Psychological Sciences, Tel Aviv University, Tel-Aviv, Israel
| | - Liat Tikotzky
- Department of Psychology, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | | | - Avi Sadeh
- School of Psychological Sciences, Tel Aviv University, Tel-Aviv, Israel
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Öztürk M, Boran P, Ersu R, Peker Y. Possums-based parental education for infant sleep: cued care resulting in sustained breastfeeding. Eur J Pediatr 2021; 180:1769-1776. [PMID: 33507387 DOI: 10.1007/s00431-021-03942-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 01/01/2021] [Accepted: 01/11/2021] [Indexed: 11/25/2022]
Abstract
For infants and their families, sleep consolidation is important in maturing neural and circadian rhythms, and in family dynamics. The Possums Infant Sleep Program is a cued care approach to infant sleep, responding to infant cues in a flexible manner, dialing down the infant's sympathetic nervous system. The current study evaluated the effect of the Possums program on infant sleep and breastfeeding in infants (6-12 months) from a well-child outpatient clinic in Turkey, with the program intervention group (n = 91) compared with usual care (n = 92). In total, 157 mother-infant dyads completed the study. Infant sleep and breastfeeding rates were assessed at baseline and after 3 months. Nocturnal wakefulness, daytime sleep duration, naps, and night wakening decreased in both groups. Nocturnal sleep duration and the longest stretch of time the child was asleep during the night increased significantly in both groups without any change in total sleep duration. Night wakening was significantly lower and nocturnal sleep duration was significantly higher in the intervention group. However, mixed effects model analyses indicated no significant differences between the groups on any of the sleep outcomes after adjusting for confounders. Despite this, breastfeeding rates were significantly higher in the intervention group compared with those in the usual care group at follow-up.Conclusion: The Possum infant sleep program provided equivalent positive results on sleep parameters compared to usual care while advocating a more cued response. The critical difference was evident in sustained breastfeeding. What is Known: • Responsive sleep programs produce sleep consolidation, by responding to the infant's cues without ignoring, and then gradually reducing parental interaction. • Breastfeeding to sleep may be considered an undesirable sleep association in some infant sleep interventions. What is New: • The Possums Infant Sleep Program provided equivalent positive results to usual care while advocating a more cued response. • The critical difference was in sustaining breastfeeding, and the program was associated with better breastfeeding rates.
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Affiliation(s)
- Merve Öztürk
- Division of Social Pediatrics, Department of Pediatrics, School of Medicine, Marmara University, Istanbul, Turkey
| | - Perran Boran
- Division of Social Pediatrics, Department of Pediatrics, School of Medicine, Marmara University, Istanbul, Turkey.
| | - Refika Ersu
- Division of Pediatric Pulmonology, School of Medicine, Marmara University, Istanbul, Turkey.,Division of Pediatric Pulmonology, Children's Hospital of Eastern Ontario, University of Ottawa, Ottawa, Canada
| | - Yüksel Peker
- Department of Pulmonary Medicine, School of Medicine, Koc University, Istanbul, Turkey.,Department of Clinical Sciences, Respiratory Medicine and Allergology, Faculty of Medicine, Lund University, Lund, Sweden
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45
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Dimitratos SM, Brown H, Shafizadeh T, Kazi S, Altmann T, Ostrer B. Symptomatic relief from at-home use of activated Bifidobacterium infantis EVC001 probiotic in infants: results from a consumer survey on the effects on diaper rash, colic symptoms, and sleep. Benef Microbes 2021; 12:27-34. [PMID: 34057053 DOI: 10.3920/bm2020.0229] [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] [Indexed: 12/20/2022]
Abstract
The gut microbiome during infancy is directly involved in the digestion of human milk, development of the immune system, and long-term health outcomes. Gut dysbiosis in early life has been linked to multiple short-term ailments, from diaper dermatitis and poor stooling habits, to poor sleep and fussiness, with mixed results in the scientific literature on the efficacy of probiotics for symptom resolution. Despite the growing interest in probiotics for consumer use, observed symptomatic relief is rarely documented. This study aims to evaluate observed symptomatic relief from at-home use of activated Bifidobacterium infantis EVC001 in infants. Consumer feedback was collected over a 2-year period via a 30-day post-purchase online survey of B. infantis EVC001 (Evivo®) customers. Outcome measures included observed changes in diaper rash, symptoms of colic, and sleep behaviours in infants fed B. infantis EVC001. A total of 1,621 respondents completed the survey. Before purchasing B. infantis EVC001, the majority of respondents visited the product website, researched infant probiotics online, or consulted with their doctor or other healthcare professional. Of the participants whose infants had ever experienced diaper rash, 72% (n=448) reported improvements, and 57% of those reported complete resolution of this problem. Of those who responded to questions about gassiness/fussiness, naptime sleep, and night-time sleep behaviours, 63% (n=984), 33% (n=520), and 52% (n=806) reported resolution or improvements, respectively. Although clinical data regarding probiotic use are often inconclusive for symptom resolution, home use of B. infantis EVC001 in infants improved diaper rash, gassiness/fussiness, and sleep quality within the first week of use in a significant number of respondents who engaged in a voluntary post-purchase survey. These outcomes may be a result of the unique genetic capacity of B. infantis EVC001 to colonise the infant gut highlighting the importance of strain selection in evaluating the effects of probiotic products.
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Affiliation(s)
- S M Dimitratos
- Department of Nutrition, University of California, Davis, Davis, CA 95616, USA
| | - H Brown
- Evolve BioSystems, Inc, Davis, CA 95618, USA
| | | | - S Kazi
- Evolve BioSystems, Inc, Davis, CA 95618, USA
| | - T Altmann
- Children's Hospital Los Angeles, Los Angeles, CA 90027, USA.,Calabasas Pediatrics Wellness Center, Calabasas, CA 91302, USA
| | - B Ostrer
- Evolve BioSystems, Inc, Davis, CA 95618, USA
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46
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Ash T, Taveras EM, Redline S, Haneuse S, Quante M, Davison K. Contextual and Parenting Factors Contribute to Shorter Sleep Among Hispanic/Latinx Compared to Non-Hispanic White Infants. Ann Behav Med 2021; 55:424-435. [PMID: 32914840 DOI: 10.1093/abm/kaaa062] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Sleep is an important aspect of child development and health. Disparities in childhood sleep have been observed as early as infancy, but little is known about the factors contributing to them. PURPOSE The objective of this study was to examine whether intrinsic, contextual, and parenting factors contribute to differences in sleep duration between Hispanic/Latinx and non-Hispanic white infants at 6 months of age. METHODS We analyzed data of 119 Hispanic/Latinx and 146 non-Hispanic white infants in Rise & SHINE, a prospective birth cohort study of mother-infant dyads. Mothers reported their infant's sleep patterns using the Brief Infant Sleep Questionnaire at 6 months. Mothers also completed surveys measuring intrinsic (sex, gestational length, and birth weight), contextual (cultural, environmental, and familial), and parenting (behaviors and practices) factors. We used multivariable linear and logistic regression analyses to examine the contributing effects of these clusters of variables on the association between racial/ethnic background and infant sleep duration. RESULTS Hispanic/Latinx infants slept 38 min less than white infants at 6 months (β: -0.63 [95% confidence interval: -1.07, -0.19]) and were nearly three times more likely to not meet the minimum sleep recommendation. The differences persisted after adjustment for intrinsic factors but were attenuated after additional adjustment for contextual and parenting factors, especially having a foreign-born mother and later bedtime. CONCLUSIONS The results of this study demonstrate that differences in sleep duration among Hispanic/Latinx infants compared to their white counterparts are present as early as 6 months of age and that context and parenting matter.
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Affiliation(s)
- Tayla Ash
- Department of Behavioral and Social Sciences, Brown School of Public Health, Providence, RI, USA.,Center for Health Promotion and Health Equity, Brown School of Public Health Providence, RI, USA
| | - Elsie M Taveras
- Division of General Academic Pediatrics, Department of Pediatrics, Mass General Hospital for Children, Boston, MA, USA.,Department of Nutrition, Harvard Chan School of Public Health, Boston, MA, USA
| | - Susan Redline
- Division of Sleep and Circadian Disorders, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Sebastien Haneuse
- Department of Biostatistics, Harvard Chan School of Public Health, Boston, MA, USA
| | - Mirja Quante
- Division of Sleep and Circadian Disorders, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.,Department of Neonatology, University of Tuebingen, Tuebingen, Germany
| | - Kirsten Davison
- Department of Nutrition, Harvard Chan School of Public Health, Boston, MA, USA.,Boston College School of Social Work, Boston, MA, USA
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47
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Fangupo LJ, Haszard JJ, Reynolds AN, Lucas AW, McIntosh DR, Richards R, Camp J, Galland BC, Smith C, Taylor RW. Do sleep interventions change sleep duration in children aged 0-5 years? A systematic review and meta-analysis of randomised controlled trials. Sleep Med Rev 2021; 59:101498. [PMID: 34029803 DOI: 10.1016/j.smrv.2021.101498] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Revised: 04/12/2021] [Accepted: 04/22/2021] [Indexed: 11/25/2022]
Abstract
This review investigated whether randomised controlled trials attempting to improve sleep or prevent sleep problems in 0-5 year olds influenced nocturnal sleep duration, day-time naps, or 24-h sleep. Medline (Ovid), EMBASE, and CINAHL were searched from inception until 9 July 2020 and supplemented with hand searching. Search results were screened, eligible data were extracted, and risk of bias was assessed by at least two reviewers. Of 8571 publications considered, 32 trials which used a variety of subjective and objective sleep measurements were included in generic inverse variance random effects meta-analysis of nocturnal (n = 24), day-time (n = 14), and 24-h (n = 13) sleep duration. Overall, sleep interventions increased nocturnal sleep duration by a mean of 9 min (95% CI 4.1 to 13.8, I228%) per night when compared with no sleep intervention. Increases were predominantly seen in sleep-only, rather than multi-component interventions. Total 24-h sleep duration tended to increase by a similar amount (8.6 min (95% CI -2.7 to 19.8, I2 = 59%)), but this was mainly only seen in studies that assessed sleep using diaries. There was no evidence that interventions changed day-time sleep duration. Future studies should involve sleep-only rather than multi-component interventions, and use objective sleep measures (reviewregistry857).
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Affiliation(s)
| | | | | | - Albany W Lucas
- Centre for Pacific Health, University of Otago, New Zealand
| | | | | | - Justine Camp
- Department of Medicine, University of Otago, New Zealand
| | - Barbara C Galland
- Department of Women and Children's Health, University of Otago, New Zealand
| | - Claire Smith
- Department of Human Nutrition, University of Otago, New Zealand
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48
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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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Romeo DM, Cordaro G, Macchione E, Venezia I, Brogna C, Mercuri E, Bruni O. Application of the Sleep Disturbance Scale for Children (SDSC) in infants and toddlers (6-36 months). Sleep Med 2021; 81:62-68. [PMID: 33639483 DOI: 10.1016/j.sleep.2021.02.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Revised: 01/27/2021] [Accepted: 02/01/2021] [Indexed: 12/01/2022]
Abstract
OBJECTIVES The aim of the present study is to assess the psychometric properties of the Sleep Disturbance Scale for Children (SDSC) in an Italian population of infants and toddlers. METHODS The SDSC was distributed to the primary caregivers of infants aged 6-36 months recruited via nurseries in the urban area of Rome. Reliability analysis for evaluating internal consistency and item-total correlation coefficients, and factor analysis were performed. RESULTS During a 12-months study period, a total of 193 healthy infants (aged 6-36 months) were evaluated using a 22-item version of the SDSC for Italian infants and toddlers. Three of the 22 original items displayed a low item-total correlation (<30) and a low frequency and were eventually removed, resulting in a 19 items questionnaire. Six factors were derived from the factor analysis using the principal component method of extraction and rotated with the varimax method: Difficulty in initiating sleep, Difficulty in maintaining sleep, Sleep breathing disorders, Parasomnias, Disorders of excessive somnolence and Sleep hyperhidrosis. The SDSC adapted for infants and toddlers showed a good level of internal consistency (Cronbach's alpha: 0.83). CONCLUSIONS The statistical analysis, the internal consistency and the factor analysis encourage the use of SDSC as an evaluation tool even at this age. The six factors extracted represent the most common areas of sleep disorders at this age and could therefore help clinicians to detect the areas that need a deeper investigation.
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Affiliation(s)
- Domenico M Romeo
- Pediatric Neurology Unit, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy; Pediatric Neurology Unit, Università Cattolica Del Sacro Cuore, Rome, Italy.
| | - Giorgia Cordaro
- Pediatric Neurology Unit, Università Cattolica Del Sacro Cuore, Rome, Italy
| | - Elisa Macchione
- Pediatric Neurology Unit, Università Cattolica Del Sacro Cuore, Rome, Italy
| | - Ilaria Venezia
- Pediatric Neurology Unit, Università Cattolica Del Sacro Cuore, Rome, Italy
| | - Claudia Brogna
- Pediatric Neurology Unit, Università Cattolica Del Sacro Cuore, Rome, Italy; Neuropsychiatric Unit ASL Avellino, Via Degli Imbimbo 10/12, 83100 Avellino, Italy
| | - Eugenio Mercuri
- Pediatric Neurology Unit, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy; Pediatric Neurology Unit, Università Cattolica Del Sacro Cuore, Rome, Italy
| | - Oliviero Bruni
- Department of Developmental and Social Psychology, Sapienza University of Rome, Italy
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50
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Valla L, Småstuen MC, Andenæs R, Misvær N, Olbjørn C, Helseth S. Association between colic and sleep problems in infancy and subsequent development, emotional and behavioral problems: a longitudinal study. BMC Pediatr 2021; 21:23. [PMID: 33407244 PMCID: PMC7788887 DOI: 10.1186/s12887-020-02483-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Accepted: 12/20/2020] [Indexed: 11/24/2022] Open
Abstract
Background Sleep and colic problems in infancy have been linked to adverse health outcome, but there is limited knowledge of the association between sleep and colic problems in infancy and subsequent development, emotional and behavior problems in young children. The aim of the present study was to examine whether there is an associations between infants’ crying and sleep problems at 6 months and behavioral and development problems at 18 months, 3 and 5 years. Methods This study is based on the Norwegian Mother, Father and Child Cohort Study (MoBa), conducted at the Norwegian Institute of Public Health from June 1999 to December 2008. A total of 86,724 children were included. Colic and sleep (sleep duration, nocturnal awakenings and easy to put to bed) was assessed by mother-reports. Z-scores were used to assess differences between groups of children (e.g. having colic or not, having a sleep problem or not). Emotional and behavioral problems were measured with items from the Child Behavior Checklist. Development problems were measured with items from The Ages and Stages Questionnaire. Results Infants with colic scored significantly lower on development at 5 years (B=-0.10, CI [− 0.14 to - 0.06]) and higher on internalizing problems both at 3 years (B=0.15. CI [0.11 to 0.18]) and 5 years (B=0.17. CI [0.12 to 0.21]) than the reference population. Children who awoke frequently and were more difficult to put to bed at 6 months scored significantly lower on development at 18 months and 3 and 5 years, and higher on internalizing behavior problems at 3 and 5 years (B=0.18 and B=0.16). Children with shorter sleep duration at 6 months had more internalizing behavior problems at 3 years (B=0.14. CI [0.07 to 0.21]) and 5 years (B=0.15. CI [0.05 to 0.25]) than the reference population. Conclusions Colic and sleep problems early in life should be taken into account as risk factors for development and behavioral problems within the first 5 years of a child’s life. Supplementary Information The online version contains supplementary material available at 10.1186/s12887-020-02483-1.
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Affiliation(s)
- Lisbeth Valla
- Department of Nursing and Health promotion,Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway.
| | - Milada Cvancarova Småstuen
- Department of Nursing and Health promotion,Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
| | - Randi Andenæs
- Department of Nursing and Health promotion,Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
| | - Nina Misvær
- Department of Nursing and Health promotion,Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
| | - Christine Olbjørn
- Department of Pediatric and Adolescent Medicine, Akershus University Hospital, Lørenskog, Norway.,Institute of Clinical Medicine, Campus Ahus, University of Oslo, Oslo, Norway
| | - Sølvi Helseth
- Department of Nursing and Health promotion,Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
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