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Adams EL, Edgar A, Mosher P, Burkart S, Armstrong B, Glenn Weaver R, Beets MW, Rebekah Siceloff E, Savidge M, Dugger R, Prinz RJ. A comparison of perceived barriers to optimal child sleep among families with low and high income. Sleep Health 2024; 10:182-189. [PMID: 38245475 PMCID: PMC11089667 DOI: 10.1016/j.sleh.2023.12.004] [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: 05/12/2023] [Revised: 08/15/2023] [Accepted: 12/15/2023] [Indexed: 01/22/2024]
Abstract
OBJECTIVE Families with low-income experience suboptimal sleep compared to families with higher-income. Unique drivers likely contribute to these disparities, along with factors that universally impede sleep patterns, despite income level. To inform intervention tailoring, this mixed-methods study gathered parent's perceptions about child sleep challenges to identify similarities/differences in families with lower-income and higher-income. METHODS Parents who experienced difficulties with their child (ages 2-4years) sleep were categorized as lower income (n = 15; $30,000 ± 17,845/year) or higher income (n = 15; $142,400 ± 61,373/year). Parents completed a survey and semistructured interview to explore barriers and facilitators for child sleep. Two coders independently evaluated transcripts for lower-income and higher-income groups using inductive analyses. Constant-comparison methods generated themes and characterized similarities/differences by income group. RESULTS Groups were similar in themes related to diverse bedtime routines, nighttime struggles with child sleep, parent strategies to reduce night wakings, parent effort to provide a sleep-promoting environment, and presence of electronic rules. Groups differed in themes related to factors influencing routine setting (eg, lower income: external factors influencing routines; higher income: personal attributes for structure), parent appraisal of child sleep (eg, higher income: ambivalence; lower income: mostly negative appraisal), nap timing and duration (eg, lower income: longer naps), and strategy utilization and pursuit of resources (eg, higher income: more parents tried various strategies and accessed online/print resources). CONCLUSIONS Parents experienced many similar barriers to child sleep, with a few distinct differences by income group. These findings can inform future intervention components for all families, as well as customized components to address the unique needs of families across income levels.
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Affiliation(s)
- Elizabeth L Adams
- Department of Exercise Science, University of South Carolina, Columbia, South Carolina, United States; Research Center for Child Well-Being, University of South Carolina, Columbia, South Carolina, United States.
| | - Amanda Edgar
- Research Center for Child Well-Being, University of South Carolina, Columbia, South Carolina, United States
| | - Peyton Mosher
- Department of Exercise Science, University of South Carolina, Columbia, South Carolina, United States
| | - Sarah Burkart
- Department of Exercise Science, University of South Carolina, Columbia, South Carolina, United States; Research Center for Child Well-Being, University of South Carolina, Columbia, South Carolina, United States
| | - Bridget Armstrong
- Department of Exercise Science, University of South Carolina, Columbia, South Carolina, United States; Research Center for Child Well-Being, University of South Carolina, Columbia, South Carolina, United States
| | - R Glenn Weaver
- Department of Exercise Science, University of South Carolina, Columbia, South Carolina, United States; Research Center for Child Well-Being, University of South Carolina, Columbia, South Carolina, United States
| | - Michael W Beets
- Department of Exercise Science, University of South Carolina, Columbia, South Carolina, United States; Research Center for Child Well-Being, University of South Carolina, Columbia, South Carolina, United States
| | - E Rebekah Siceloff
- Research Center for Child Well-Being, University of South Carolina, Columbia, South Carolina, United States
| | - Meghan Savidge
- Department of Exercise Science, University of South Carolina, Columbia, South Carolina, United States
| | - Roddrick Dugger
- Department of Exercise Science, University of South Carolina, Columbia, South Carolina, United States
| | - Ronald J Prinz
- Research Center for Child Well-Being, University of South Carolina, Columbia, South Carolina, United States; Department of Psychology, University of South Carolina, Columbia, South Carolina, United States
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Hash JB, Walker AJ, Ward TM, Oxford ML, Spieker SJ. Trying to Do What's Best: Maternal Perspectives About Toddler Sleep Health Among an Underresourced Sample of Mothers With Diverse Racial and Ethnic Identities. J Pediatr Health Care 2024; 38:160-171. [PMID: 38429028 PMCID: PMC10987074 DOI: 10.1016/j.pedhc.2023.12.008] [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: 06/20/2023] [Revised: 11/29/2023] [Accepted: 12/03/2023] [Indexed: 03/03/2024]
Abstract
INTRODUCTION This study describes mothers' knowledge, attitudes, beliefs, and practices about their toddler's sleep health among an underresourced sample of mothers with diverse racial and ethnic identities. METHOD This was a descriptive qualitative study with 16 mothers and their 12- to 36-month-old child. Mothers completed a semistructured, audio-recorded interview about their toddler's sleep health. Data were analyzed using inductive content analysis on the basis of established methods. RESULTS Mothers self-identified as 18.8% Black, 43.8% White, 12.5% multiracial, 25.0% other race, and 37.5% Hispanic. Of the mothers, 80.0% reported a past year household income of ≤ $40,000. A core construct, "Trying to do What's Best," emerged from the interview data, and this construct included three domains: Getting Good Sleep, Getting Thrown Off, and Rolling With It. DISCUSSION Findings support future strengths-based and multilevel sleep health-promoting interventions.
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Adams EL, Edgar A, Mosher P, Armstrong B, Burkart S, Weaver RG, Beets MW, Siceloff ER, Prinz RJ. Barriers to Optimal Child Sleep among Families with Low Income: A Mixed-Methods Study to Inform Intervention Development. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:862. [PMID: 36613199 PMCID: PMC9820071 DOI: 10.3390/ijerph20010862] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 12/20/2022] [Accepted: 12/27/2022] [Indexed: 06/17/2023]
Abstract
This study gathered formative data on barriers to optimal child sleep to inform the development of a sleep intervention for parents of preschool-aged children in low-income households. Parents (n = 15, age: 34 ± 8 years, household income: $30,000 ± 17,845/year) reporting difficulties with their child's sleep participated in this study. Mixed methods included an online survey and semi-structured phone interview. Items assessed barriers/facilitators to optimal child sleep and intervention preferences. Interview transcripts were coded using inductive analyses and constant-comparison methods to generate themes. Derived themes were then mapped onto the Theoretical Domains Framework to contextualize barriers and inform future intervention strategies. Themes that emerged included: stimulating bedtime activities, child behavior challenges, variability in children's structure, parent work responsibilities, sleep-hindering environment, and parent's emotional capacity. Parent's intervention preferences included virtual delivery (preferred by 60% of parents) to reduce barriers and provide flexibility. Mixed preferences were observed for the group (47%) vs. individual (53%) intervention sessions. Parents felt motivated to try new intervention strategies given current frustrations, the potential for tangible results, and knowing others were in a similar situation. Future work will map perceived barriers to behavior change strategies using the Behavior Change Wheel framework to develop a parenting sleep intervention.
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Affiliation(s)
- Elizabeth L. Adams
- Department of Exercise Science, University of South Carolina, 921 Assembly Street, Columbia, SC 29208, USA
- Research Center for Child Well-Being, University of South Carolina, 1400 Pickens Street, Suite 400, Columbia, SC 29201, USA
| | - Amanda Edgar
- Research Center for Child Well-Being, University of South Carolina, 1400 Pickens Street, Suite 400, Columbia, SC 29201, USA
| | - Peyton Mosher
- Department of Exercise Science, University of South Carolina, 921 Assembly Street, Columbia, SC 29208, USA
| | - Bridget Armstrong
- Department of Exercise Science, University of South Carolina, 921 Assembly Street, Columbia, SC 29208, USA
- Research Center for Child Well-Being, University of South Carolina, 1400 Pickens Street, Suite 400, Columbia, SC 29201, USA
| | - Sarah Burkart
- Department of Exercise Science, University of South Carolina, 921 Assembly Street, Columbia, SC 29208, USA
- Research Center for Child Well-Being, University of South Carolina, 1400 Pickens Street, Suite 400, Columbia, SC 29201, USA
| | - R. Glenn Weaver
- Department of Exercise Science, University of South Carolina, 921 Assembly Street, Columbia, SC 29208, USA
- Research Center for Child Well-Being, University of South Carolina, 1400 Pickens Street, Suite 400, Columbia, SC 29201, USA
| | - Michael W. Beets
- Department of Exercise Science, University of South Carolina, 921 Assembly Street, Columbia, SC 29208, USA
- Research Center for Child Well-Being, University of South Carolina, 1400 Pickens Street, Suite 400, Columbia, SC 29201, USA
| | - E. Rebekah Siceloff
- Research Center for Child Well-Being, University of South Carolina, 1400 Pickens Street, Suite 400, Columbia, SC 29201, USA
| | - Ronald J. Prinz
- Research Center for Child Well-Being, University of South Carolina, 1400 Pickens Street, Suite 400, Columbia, SC 29201, USA
- Department of Psychology, Barnwell College, University of South Carolina, 1512 Pendleton Street, Columbia, SC 29208, USA
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Rönnlund H, Elovainio M, Virtanen I, Heikkilä AR, Raaska H, Lapinleimu H. Child Eveningness as a Predictor of Parental Sleep. CHILDREN (BASEL, SWITZERLAND) 2022; 9:children9121968. [PMID: 36553411 PMCID: PMC9777097 DOI: 10.3390/children9121968] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Revised: 12/12/2022] [Accepted: 12/13/2022] [Indexed: 12/23/2022]
Abstract
Child eveningness has been associated with many adverse outcomes for children. The aim of this study was to assess whether child eveningness poses a risk to parental sleep quality in follow-up. A total of 146 children (57% adopted, 47% boys, mean age at follow-up 5.1 years [standard deviation 1.7]) completed a 1-week actigraph recording to analyze their sleep twice, 1 year apart. The parents completed the Child ChronoType Questionnaire for their child and a short version of the Morningness-Eveningness Questionnaire for themselves and the Jenkins Sleep Scale for their sleep quality. Linear regression analyses showed that subjective parental sleeping problems at baseline were associated with subjective parental sleeping problems at follow-up. A morning-type child decreased the risk of parental sleeping problems at the 1-year follow-up compared to the child evening chronotype. Additionally, the child intermediate chronotype decreased the risk of maternal sleeping problems at the 1-year follow-up compared to the evening chronotype of the child. Parents of evening-type children experienced more sleeping problems in the follow-up, compared to parents of morning-type children. This finding encourages parents and professionals to steer the diurnal rhythm of evening-type children toward an earlier daily routine.
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Affiliation(s)
- Hanni Rönnlund
- Department of Paediatrics and Adolescent Medicine, University of Turku, 20014 Turku, Finland
- Kaarina Health Center, 20780 Kaarina, Finland
- Correspondence:
| | - Marko Elovainio
- Department of Psychology and Logopedics, University of Helsinki, 00014 Helsinki, Finland
- National Institute for Health and Welfare, 00271 Helsinki, Finland
| | - Irina Virtanen
- Department of Clinical Neurophysiology, Turku University Hospital, 20521 Turku, Finland
- Department of Clinical Neurophysiology, University of Turku, 20521 Turku, Finland
| | - Anna-Riitta Heikkilä
- Department of Pediatrics, University of Helsinki, 00014 Helsinki, Finland
- Department of Pediatrics, Helsinki University Hospital, 00029 Helsinki, Finland
| | - Hanna Raaska
- Department of Child Psychiatry, Helsinki University Hospital, 00029 Helsinki, Finland
| | - Helena Lapinleimu
- Department of Paediatrics and Adolescent Medicine, University of Turku, 20014 Turku, Finland
- Department of Paediatrics and Adolescent Medicine, Turku University Hospital, 20521 Turku, Finland
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Hartman AG, McKendry S, Bendixen R. Comparing contributors of parental sleep health in families with and without a child with Duchenne muscular dystrophy. Sleep Health 2021; 8:107-113. [PMID: 34924347 DOI: 10.1016/j.sleh.2021.11.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Revised: 10/29/2021] [Accepted: 11/04/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND The sleep health of caregivers of children with Duchenne muscular dystrophy (DMD) is often overlooked in clinical practice and research. This study characterizes the sleep health of caregivers of children with DMD (4-17 years) compared to parents of age-matched, unaffected children. We explore potential contributors to parental sleep efficiency and hypothesize that child awakenings will have a considerable influence on parental sleep efficiency. METHODS In this observational study, parents and their children were asked to wear the ActiGraph GT9X Link at night for 1 month. From these data, actigraphy variables (eg, percent sleep efficiency, nocturnal awakenings) were calculated and averaged for parents and children. We also used the Pittsburgh Sleep Quality Index (PSQI) to measure subjective sleep quality. MAIN FINDINGS Parents in the DMD group (n = 25, M = 84.5%) had significantly worse sleep efficiency compared to controls (n = 15, M = 87.8%, p = .048). This difference was sustained after controlling for parent age, child age, and average child awakenings (F(4, 23) = 2.68, p= .057, R2 = .32). Additionally, more parents in the DMD group scored as "poor sleepers" on the PSQI (above 5, 50%) compared to controls (23%), suggesting a strong, yet not statistically significant association between subjective poor sleep and group (χ2(1) = 2.47, p = .116, OR = 3.33). CONCLUSION Parents of children with DMD exhibit both objective and subjective differences suggesting their sleep is impaired. Interestingly, these sleep concerns are not significantly explained by child awakenings as hypothesized. Future research is needed to fully understand the prevalence and cause of poor sleep in a larger group of DMD caregivers as well as direct care for caregivers of children with disabilities.
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Affiliation(s)
- Amy G Hartman
- Department of Occupational Therapy, The University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
| | - Sarah McKendry
- Department of Occupational Therapy, The University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Roxanna Bendixen
- Department of Occupational Therapy, The University of Pittsburgh, Pittsburgh, Pennsylvania, USA
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Dai Y, Liu J. Parental perceived child sleep problems: A concept analysis. J SPEC PEDIATR NURS 2021; 26:e12327. [PMID: 33493387 DOI: 10.1111/jspn.12327] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Revised: 12/15/2020] [Accepted: 01/05/2021] [Indexed: 02/05/2023]
Abstract
PURPOSE This paper aims to delineate a conceptual analysis of parental perceived child sleep problems. DESIGN AND METHODS Rodger's evolutionary approach to concept analysis was employed. A systematic literature search of PubMed, CINAHL, Medline, and PsycINFO was conducted from inception to June 2020. Peer-reviewed papers written in English focusing on parental perception of their children's sleep problems were included. RESULTS A total of 47 papers were included for analysis. Parental perceived child sleep problems can be defined as parental reliance on their observations and beliefs, and perceived locus of control to appraise an array of children's sleep-related signs and behaviors, which may contain bias but still reflects certain aspects of children's sleep health status. A wide range of physiological, psychosocial, familial, environmental, and cultural factors may contribute to parental perceived child sleep problems, which may further contribute to parent-child dyads' physical and mental health as well as the whole family's general wellness. PRACTICE IMPLICATIONS Defining the concept of parental perceived child sleep problems facilitate health professionals a foundation for consistent use, understanding, and evaluation of parent-reported child sleep outcome. Future research on the standard conceptual and operational definition of parental perceived child sleep problem, and its potential antecedents and consequences is warranted. The characteristic of parental perceived sleep problems, together with child sleep history and objective sleep measures should be integrated to evaluate child sleep health.
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Affiliation(s)
- Ying Dai
- Schools of Nursing, Leonard Davis Institute, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Jianghong Liu
- Schools of Nursing and Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
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Muller D, Paine SJ, Wu LJ, Signal TL. "Their Sleep Means More Harmony": Maternal Perspectives and Experiences of Preschoolers' Sleep in Ethnically and Socioeconomically Diverse Families in Aotearoa/New Zealand. QUALITATIVE HEALTH RESEARCH 2019; 29:2023-2034. [PMID: 30973062 DOI: 10.1177/1049732319842156] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Viewing sleep through a socioecological lens, maternal perceptions, and experiences of preschoolers' sleep were explored using semistructured interviews with 15 Māori (indigenous) and 16 non-Māori mothers, with low- and high socioeconomic position. Thematic analysis identified four themes: child happiness and health, maternal well-being, comfort and connection, and family functioning and harmony. Mothers perceived healthy preschooler sleep as supporting children's mental and physical health, parents' sleep/wake functioning, family social cohesion and emotional connectedness, and poor preschooler sleep as negatively influencing child, maternal and family well-being. Although many experiences were shared, some perceptions of sleep and sleep practices differed between mothers. Influences included health paradigms, socioeconomic circumstances, maternal autonomy, employment, parenting approaches, and societal expectations. Healthy preschooler sleep is valued by mothers and may play a protective role in family health and resilience. Preschooler sleep initiatives need to be responsive to maternal perspectives and address societal drivers of sleep experiences.
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Affiliation(s)
| | | | - Lora J Wu
- Massey University, Wellington, New Zealand
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Pinato L, Ribeiro EM, Leite RFP, Lopes TF, Pessoa ALS, Guissoni Campos LM, Piffer GE, Souza ALDM, Giacheti CM. Sleep findings in Brazilian children with congenital Zika syndrome. Sleep 2019; 41:4791871. [PMID: 29325155 DOI: 10.1093/sleep/zsy009] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Study Objectives Zika virus infection during pregnancy may result in congenital Zika syndrome (CZS), whose characteristics are being described. Methods The present study aimed to investigate the sleep characteristics of 136 infants/toddlers (88 with CZS and 48 with typical development (TD), age and gender matched, 60% girls and 40% boys in both groups) using the Brief Infant Sleep Questionnaire. The ages of children in both groups ranged from 5 to 24 months (CZS 15.9 ± 0.4 vs. TD 15.8 ± 1.0 months, P= 0.90). Results The results show that 34.1% of CZS and 2% of TD children were defined as poor sleepers, 15% of CZS and 2% of TD children remained awake at night for a period longer than 1 hour, and 24% of CZS and 2% of TD children slept less than 9 hours. The CZS group showed shorter total sleep time (CZS 11.24 ± 2.6 vs. TD 12.02 ± 1.9 hours, P= 0.03) and shorter nocturnal sleep duration than the TD group (CZS 8.2 ± 0.2 vs. TD 9.4 ± 0.2 hours, P= 0.0002). In contrast to the control group (P= 0.02, r= -0.34), in the CZS group, no correlation was found between age and nocturnal wakefulness. Future studies should explore these data in relation to the development and maturation of the central nervous system of these children. Conclusions Considering the well-known consequences of poor sleep quality on health in several populations, the presence of sleep disorders should be considered in CZS using multidisciplinary treatments.
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Affiliation(s)
- Luciana Pinato
- São Paulo State University - UNESP, Marilia, São Paulo, Brazil
| | - Erlane M Ribeiro
- Albert Sabin Children's Hospital, Fortaleza, Ceará, Brazil.,Christus University Center, Fortaleza, Ceará, Brazil
| | | | - Thayse F Lopes
- Albert Sabin Children's Hospital, Fortaleza, Ceará, Brazil
| | - André L S Pessoa
- Albert Sabin Children's Hospital, Fortaleza, Ceará, Brazil.,State University of Ceará (UECE), Fortaleza, Ceará, Brazil
| | | | | | - Ana L D M Souza
- São Paulo State University - UNESP, Marilia, São Paulo, Brazil
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