The effects of bed sharing on sleep: From partners to pets

A narrative review of research linking non-sexual social touch to sleep quality

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.

Sources of attitudes towards parent-child co-sleeping and their effects: A systematic scoping review

Parent-child co-sleeping is a common practice in many cultures, although in Western countries, families who engage in parent-child co-sleeping can encounter attitudes about co-sleeping that feel critical from the people around them, as it is not commonly accepted and often stigmatized. This systematic scoping review examined and synthesized the available literature on the attitudes about parent-child co-sleeping that people encounter, their origins, and their effect on parents' own attitudes and behaviors. A total of 9796 abstracts were screened, and 33 studies were included. While the scope of the literature on this topic was narrow, this review demonstrated that parents/caregivers mostly encounter encouraging attitudes about co-sleeping from their extended family members and within their culture and discouraging attitudes from healthcare professionals. Findings suggest that encouraging attitudes enhance the likelihood of parents engaging and continuing with co-sleeping behavior, while discouraging attitudes can lead to the avoidance of parents discussing sleep with their healthcare professionals and can cause conflicts with other family members, including partners. Based on these findings, we conclude that further research is needed in several areas related to co-sleeping in Western culture, most specifically in how external attitudes influence the decision to co-sleep, as well as other behaviors and cognitions such as engagement with healthcare professionals, family satisfaction, parental self-efficacy, and overall mental health.

Development of the Couples' Sleep Conflict Scale: A new tool to assess conflict around sleep in romantic relationships

OBJECTIVE

The purpose of this study was to evaluate the psychometric properties of the Couples' Sleep Conflict Scale, a new measure designed to identify the extent of conflict around sleep in romantic relationships.

METHODS

Data from an individual sample (N = 158) and dyadic sample (N = 143 mixed-gender couples) in romantic relationships were used to examine the psychometric properties of the Couples' Sleep Conflict Scale, including internal consistency, convergent and divergent validity, and whether the factor structure differed between couples with concordant and discordant chronotypes.

RESULTS

Results revealed that the Couples' Sleep Conflict Scale fit a 1-factor solution of 5 items, a summed or mean score can be used, and that it is reliable for both men and women. In addition, more relational sleep conflict was associated with both their own and their partners' poorer sleep hygiene, worse sleep quality, and more daytime sleepiness as well as more general relationship conflict, lower relationship satisfaction, and higher anxious and avoidant attachment. Finally, we found partial measurement invariance for factor loadings, intercepts, and latent variable variances between couples with concordant vs. discordant chronotypes.

CONCLUSION

The Couples' Sleep Conflict Scale is a brief measure that can be used in both research and in health care settings to examine how sleep-related conflict can affect both sleep and relationship quality among couples.

Yours, mine, or ours? Dyadic sleep hygiene and associations with sleep quality, emotional distress, and conflict frequency in mixed-gender, bed-sharing couples

Although prior research demonstrates the interdependence of sleep quality within couples (i.e., the sleep of one partner affects the sleep of the other), little is known about the degree to which couples' sleep hygiene behaviours are concordant or discordant, and if one's own sleep hygiene or their report of their partners' sleep hygiene is related to worse relational, psychological, and sleep outcomes. In a sample of 143 mixed-gender, bed-sharing couples, each partner completed an online questionnaire consisting of the Sleep Hygiene Index (for themselves and their partner), PROMIS sleep disturbance scale, conflict frequency, PHQ-4 for anxiety and depressive symptoms, and the Perceived Stress Scale. Paired samples t-tests between partners were conducted using total and individual-item Sleep Hygiene Index scores to examine similarities and differences. Intraclass correlation coefficient (ICC) scores of dyadic reports were conducted to examine the level of agreement between each partner's sleep hygiene. Finally, we examined associations between one's own sleep hygiene and their report of their partner's sleep hygiene with both partner's sleep quality, emotional distress, and conflict frequency in a dyadic structural equation model with important covariates and alternative model tests. The results revealed a significant difference between men's (M = 14.45, SD = 7.41) and women's total score self-report sleep hygiene ([M = 17.67, SD = 8.27]; t(142) = -5.06, p < 0.001) and partners only had similar sleep hygiene for 5 out of the 13 items. Examining dyadic reports of sleep hygiene revealed that partners had moderate agreement on their partners' sleep hygiene (0.69-0.856). The results from the dyadic structural equation model revealed that poorer sleep hygiene was associated with one's own poor sleep quality, higher emotional distress, and more frequent relational conflict. For both men and women a poorer report of a partner's sleep hygiene was associated with one's own report of higher relationship conflict. Finally, men's poorer report of a partner's sleep hygiene was related better to their own sleep quality but was related to poorer sleep quality for their partners. These results have implications for sleep promotion and intervention efforts as well as for couple relationship functioning.

Co-sleeping with pets, stress, and sleep in a nationally-representative sample of United States adults

This cross-sectional study tested the direct and stress-buffering effects of co-sleeping with pets on human sleep characteristics in a nationally-representative sample of United States adults. Participants completed questionnaires assessing their sleep characteristics, including perceived sleep quality, perceived sleep efficiency, insomnia severity, and multidimensional sleep health. We evaluated whether co-sleeping with pets was associated with sleep characteristics and whether co-sleeping with pets moderated the association of stress and sleep characteristics. Exploratory analyses examined whether sleep characteristics were impacted by number of pets, pet type, and bondedness to pets. Our final sample of 1591 participants (Mage = 46.4 years, SD = 17.5; 56% female; 76% White) included 758 participants who reported co-sleeping with pets (47.6%). Co-sleeping with pets was associated with poorer sleep characteristics-specifically, poorer perceived sleep quality and greater insomnia severity. Although higher levels of stress were associated with poorer sleep, we did not observe evidence for a stress-buffering effect of co-sleeping with pets. Exploratory analyses indicated that the negative impact of co-sleeping with pets on human sleep was associated with dog ownership but not cat ownership, more pronounced when individuals own a greater number of pets, and not impacted by bondedness to pets. Our findings contribute to emerging evidence for the impact of co-sleeping with pets on human sleep. Study was pre-registered at: https://aspredicted.org/3VN_WF6 .

Infant Safe Sleep in the District of Columbia: Better for Both

Sudden unexpected infant death (SUID) rates within the District of Columbia (DC) vary, with rates 3 times higher in certain geographical areas than the cumulative rate in DC and 7 times higher than the national rate. The majority SUIDs are due to unsafe sleep practices. Although safe sleep education and resources are available in these areas, the high sleep-related infant mortality suggests unmet barriers to infant safe sleep. We sought to investigate potential contributions to local infant mortality through focus groups regarding infant sleep practices among DC caregivers. In this qualitative study, caregivers were probed regarding barriers and facilitators of infant sleep practices. Data were collected until thematic saturation was reached, then coded. Themes were developed and revised in an iterative manner. Fifteen caregivers participated in three focus groups. Themes included sources of infant sleep knowledge, challenges for infant sleep, and motivators for infant sleep choice. All caregivers reported knowledge of safe sleep practices. Infant sleep practices varied, and included unsafe practices such as bed sharing, co-sleeping, and use of swings or bouncers for infant sleep. Challenges of adhering to safe sleep practices included infant needs, competing family demands, the overwhelming nature of newborn sleep, threats, and conflicting information. Motivators for infant sleep practices included better sleep, convenience, safety, tradition, and needs of the infant and caregiver. Although caregivers report knowledge of safe sleep recommendations, actual infant sleep practices vary and include unsafe sleep practices. More focused interventions are needed to address this gap between safe sleep knowledge and practice.

Loneliness and Marital Quality as Predictors of Older Adults' Insomnia Symptoms

The current study examined associations between marital quality, loneliness, and sleep within a nationally representative sample of older adults who participated in Wave 2 of the National Social Life, Health, and Aging Project (NSHAP). Participants (N = 559) had a spouse or partner and completed a novel sleep module that included subjective (i.e., insomnia symptoms) and objective (i.e., wake after sleep onset;WASO) markers of sleep. Upon controlling for demographics and markers of mental and physical health, a distinct pattern of findings emerged for subjective versus objective markers of sleep. Regarding subjective sleep, older adults who experienced greater loneliness reported more insomnia symptoms, but only when spousal emotional support was low-moderate. Regarding objective sleep, older adults who reported more affectionate touch from their spouse experienced less WASO. Collectively, these findings identify specific aspects of marital quality that may have unique implications for partnered older adults' subjective and objective sleep quality.

The association between loneliness, social isolation, and sleep disturbances in older adults: A follow-up study from the Swedish good aging in Skåne project

Objectives

The aim of this follow-up study was to investigate whether loneliness and social isolation in a sample of older adults, mean age of 67.4 years at baseline examination, were associated with sleep disturbances at re-examination at a mean age of 76.4 years.

Methods

The study sample consisted of 2897 participants. Data on loneliness, social isolation, and sleep disturbances were collected through questionnaires and medical examinations. Logistic regression models were constructed to identify associations between levels of loneliness and social isolation at baseline and sleep disturbances at follow-up. Sociodemographic and health-related confounding factors were controlled for in the models.

Results

Sleep disturbances were reported by 25.6% (95% CI: 24.0%-27.2%) at baseline and 23.7% (95% CI: 22.1%-25.3%) at re-examination. Odds ratios for sleep disturbances at re-examination in relation to not being lonely or socially isolated were as follows: single occasions of loneliness (OR: 1.37, 95% CI: 1.05-1.78), recurring periods/constant loneliness (OR: 1.92, 95% CI: 1.01-1.99), less severe social isolation (OR: 1.18, 95% CI: 0.78-1.79), and severe social isolation (OR: 1.88, 95% CI: 1.01-3.49).

Discussion

Sleep disturbances are common among older adults and are associated with loneliness and social isolation. Healthcare professionals should be aware of the potential effects of loneliness and social isolation when investigating sleep disturbances in older adults.

Describing skin health and disease in urban-living Aboriginal children: co-design, development and feasibility testing of the Koolungar Moorditj Healthy Skin pilot project

BACKGROUND

Indigenous children in colonised nations experience high rates of health disparities linked to historical trauma resulting from displacement and dispossession, as well as ongoing systemic racism. Skin infections and their complications are one such health inequity, with the highest global burden described in remote-living Australian Aboriginal and/or Torres Strait Islander (hereafter respectfully referred to as Aboriginal) children. Yet despite increasing urbanisation, little is known about the skin infection burden for urban-living Aboriginal children. More knowledge is needed to inform service provision, treatment guidelines and community-wide healthy skin strategies. In this pilot study, we aimed to test the feasibility and design of larger multi-site observational studies, provide initial descriptions of skin disease frequency and generate preliminary hypotheses of association.

METHODS

This project has been co-designed with local (Noongar) Elders to provide an Australian-first description of skin health and disease in urban-living Aboriginal children. In collaboration with an urban Aboriginal Community Controlled Health Organisation (Derbarl Yerrigan Health Service), we conducted a week-long cross-sectional observational cohort study of Aboriginal children (0-18 years) recruited from the waiting room. Participants completed a questionnaire, skin examination, clinical photos, and swabs and received appropriate treatment. We assessed the feasibility and impact of the pilot study.

RESULTS

From 4 to 8 October 2021, we recruited 84 Aboriginal children of whom 80 (95%) were urban-living. With a trusted Aboriginal Health Practitioner leading recruitment, most parents (or caregivers) who were approached consented to participate. Among urban-living children, over half (45/80, 56%) of parents described a current concern with their child's skin, hair and/or nails; and one-third (26/80, 33%) reported current itchy skin. Using a research-service model, 27% (21/79) of examined urban-living participants received opportunistic same-day treatment and 18% (14/79) were referred for later review.

CONCLUSIONS

This co-designed pilot study to understand skin health in urban-living Aboriginal children was feasible and acceptable, with high study participation and subsequent engagement in clinical care observed. Co-design and the strong involvement of Aboriginal people to lead and deliver the project was crucial. The successful pilot has informed larger, multi-site observational studies to more accurately answer questions of disease burden and inform the development of healthy skin messages for urban-living Aboriginal children.

Siblings' experiences of sleep disruption in families with a child with Down syndrome

OBJECTIVE

Adverse effects of sleep disruption are identified in parents who live with a child with Down Syndrome (DS), yet there is no research on siblings' experiences. This study addresses this knowledge gap.

DESIGN

A qualitative research study using semi-structured interviews to understand the experiences of siblings of a child with DS and sleep difficulties from the perspectives of parents and siblings.

PARTICIPANTS

Eleven siblings aged 5-15 years old, and 11 parents, from 8 families with a child with DS in Australia.

METHODS

Semi-structured sibling interviews explored what it was like to have a sibling with DS and sleep difficulties; the participant's own sleep; how their sleep affected how they felt during the day; how sleep impacted their family; and advice that they would give to other siblings. Parent interviews included similar topics; here we report on excerpts in which parents reference siblings. Interviews were audio recorded, transcribed verbatim, and analyzed using a reflexive thematic analysis.

RESULTS

Siblings and parents acknowledge sleep disruption for siblings; yet sleep disruption is normalized, viewed with acceptance and inevitability. Siblings report adverse effects from sleep disruption, view sleep in a relational way, and cope with sleep disruption. Parents can underestimate siblings' sleep disruption and are uncertain whether siblings' symptoms result from sleep disruption or other causes.

CONCLUSIONS

Siblings of a child with DS experience sleep disruption and may be at risk of developing long-term health problems without focused support.

A Preliminary Analysis of Psychiatric Service Dog Placements and Sleep Patterns of Partners of Veterans With PTSD

Partners of veterans diagnosed with posttraumatic stress disorder (PTSD) are at risk of a variety of challenges, and it is unknown whether psychiatric service dogs are disruptive to their sleep or provide similar benefits that are seen in the limited literature on veterans. As part of a larger clinical trial examining the efficacy of psychiatric service dogs for veterans with PTSD and their families, this study focused on sleep patterns of veterans' partners (n = 88), incorporating both subjective (clinically validated self-report surveys) and objective sleep measures (actigraphy). Linear regression was used to analyze differences in relation to group (intervention versus control) at follow up, controlling for baseline score. Results revealed no significant differences between groups for both the subjective surveys (p = 0.15; p = 0.75) and the objective actigraphy measures (p = 0.06-0.98). This suggests that psychiatric service dogs are not disruptive, nor do they provide any benefits to partner sleep. Partners had sleep patterns on par with national norms at baseline and remained at such levels at follow up. Ultimately, using both subjective and objective measures, we found no impact of psychiatric service dogs on the sleep of veterans' partners.

Pet Ownership in Aotearoa New Zealand: A National Survey of Cat and Dog Owner Practices

This study used an online survey distributed between January and March 2019 to adults residing in Aotearoa New Zealand (NZ) to investigate cat and dog owner practices. Of the 2385 respondents, 885 (37%) owned both cat/s and dog/s, while 652 (28%) and 609 (26%) owned cat/s only or dog/s only, respectively. Nine percent of respondents (n = 212) did not own a cat or dog when the survey was administered. Gaps were identified in the practices of NZ pet owners with regard to regular grooming, immunizations, and deworming treatments. It was also found that many pets, especially cats, were allowed to wander freely both inside and outside the house. Collectively, these gaps in practice raise parasitology and infection concerns which may impact negatively on animal welfare and may increase the prevalence of zoonotic diseases. This study also revealed the need to improve desexing practices, particularly in dogs. Respondents in the survey expressed the wish to have pets regardless of the financial strain they may impose, indicating that future research should focus on reducing the financial burden of pet ownership along with promoting positive pet ownership practices. Our findings suggest the need for better education resources about pet ownership which are easily accessible and target diverse populations. The findings of this study will aid in developing appropriate educational resources to promote animal welfare and increase pet-related knowledge among the NZ populace.

The development of a scale to assess children's and adolescents' sleep environments

STUDY OBJECTIVES

To develop a measure of children's sleep environments and to assess its initial reliability and validity.

METHODS

This cross-sectional study consisted of an online survey for parents of children ages 5-18 years across the United States. A total of 840 parents/caregivers (Mage = 40.6 years, standard deviation = 8.6; 72.0% female) completed surveys regarding a target child (Mage = 10.4 years, standard deviation = 3.8). The items on the scale that was developed were evaluated with exploratory and confirmatory factor analyses in separate random sample halves of the dataset. Cronbach's alpha coefficients were calculated to assess internal consistency across multiple demographic groups. We explored convergent and discriminant validity by examining associations with measures from the nomological net of constructs surrounding the children's sleep environment. Finally, we examined incremental/unique predictive validity of the full scale and its subscales through regression analyses.

RESULTS

The Children's and Adolescents' Sleep Environment Scale (13 items) produced 3 factors: general environmental hazards (7 items), availability of bedding materials (2 items), and presence of electronics (4 items). The full scale and its subscales showed strong discriminant validity, and analyses suggested that the Children's and Adolescents' Sleep Environment Scale and its subscales were generalizable across diverse demographic groups. Finally, after controlling for children's sleep hygiene, sleep disturbances, behavioral problems, and family functioning, the full-scale Children's and Adolescents' Sleep Environment Scale significantly predicted children's sleepiness, as did the general environmental hazards and presence of electronics subscales in a separate regression analysis.

CONCLUSIONS

The Children's and Adolescents' Sleep Environment Scale shows strong psychometric properties and has emerged as both a reliable and valid indicator of children's and adolescents' sleep environments and their potential impact on children's sleep and sleep-related behavior.

CITATION

Peltz JS, Rogge RD, Elmore-Staton L, Spilsbury J, Buckhalt JA. The development of a scale to assess children's and adolescents' sleep environments. J Clin Sleep Med. 2022;18(10):2353-2365.

The physical home environment and sleep: What matters most for sleep in early childhood

The physical home environment is thought to play a crucial role in facilitating healthy sleep in young children. However, relatively little is known about how various features of the physical home environment are associated with sleep in early childhood, and some of the recommendations clinicians make for improving child sleep environments are based on limited research evidence. The present study examined how observer and parent descriptions of the child's physical home environment were associated with child sleep, measured using actigraphy and parent's reports, across a year in early childhood. The study used a machine learning approach (elastic net regression) to specify which aspects of the physical home environment were most important for predicting five aspects of child sleep, sleep duration, sleep variability, sleep timing, sleep activity, and latency to fall asleep. The study included 546 toddlers (265 females) recruited at 30 months of age and reassessed at 36 and 42 months of age. Poorer quality physical home environments were associated with later sleep schedules, more variable sleep schedules, shorter sleep durations, and more parent-reported sleep problems in young children. The most important environmental predictors of sleep were room sharing with an adult, bed sharing, and quality of both the child's sleep space and the wider home environment. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Socio-Ecological Context of Sleep: Gender Differences and Couples' Relationships as Exemplars

PURPOSE OF REVIEW

We summarized recent findings on insufficient sleep and insomnia, two prominent sleep issues that impact public health. We demonstrate the socio-ecologial impact of sleep health with findings on gender and couples' relationships as exemplars.

RECENT FINDINGS

Robust gender differences in sleep duration and insomnia are due to biological and socio-ecological factors. Gender differences in insufficient sleep vary by country of origin and age whereas gender differences in insomnia reflect minoritized identities (e.g., sexual, gender). Co-sleeping with a partner is associated with longer sleep and more awakenings. Gender differences and couples' sleep were affected by intersecting social and societal influences, which supports a socio-ecological approach to sleep. Recent and seminal contributions to sleep health highlight the importance of observing individual sleep outcomes in a socio-ecological context. Novel methodology, such as global measures of sleep health, can inform efforts to improve sleep and, ultimately, public health.

Human-Animal Interaction and Perinatal Mental Health: A Narrative Review of Selected Literature and Call for Research

There is a paucity of research exploring how relationships with household pets may impact maternal mental health. We are unaware of any study to date that has examined associations between individuals' relationships with their pets and psychological adjustment in the perinatal period. Using a biobehavioral lens, this paper provides a narrative overview of the literature on perinatal mental health and human-animal interaction (HAI). We focus on the role of social relationships, stress, and stress reduction in relation to perinatal mental health; the role of HAI in perceptions of social support, stressors, and stress reduction; and gaps in empirical knowledge concerning the role of HAI in perinatal mental health. Finally, we integrate contemporary biobehavioral models of perinatal mental health and HAI (i.e., Comprehensive Model of Mental Health during the Perinatal Period and the HAI-HPA Transactional Model) to propose a new conceptual framework that depicts ways in which HAI during the perinatal period may influence maternal and child health and wellbeing. To our knowledge, this is the first paper to consider the role of HAI in biobehavioral responses and mental health during the perinatal period. We conclude with recommendations for future research and improved perinatal care.

Romantic Love and Sleep Variations: Potential Proximate Mechanisms and Evolutionary Functions

This article provides a narrative review of what is known about romantic love and sleep variations and provides possible explanations for the association. Romantic love and sleep are described using a comprehensive, unifying framework advocated by Tinbergen. We summarise the findings of studies investigating the relationship between romantic love and sleep. Sleep variations are associated with romantic love in adolescents and young adults. We then detail some proximate mechanisms that may contribute to sleep variations in people experiencing romantic love before considering potential evolutionary functions of sleep variations in people experiencing romantic love. The relationship between symptoms of psychopathology and sleep variations in people experiencing romantic love is described. With the current state of knowledge, it is not possible to determine whether sleep variations associated with romantic love are adaptations or by-products of romantic love. We conclude by proposing areas for future research.