A single-arm pilot study: can a parental sleep intervention for sleep-disturbed young children in individual settings improve children’s sleep, crying, eating, and parental distress in mothers and fathers?

Abstract

Background Early sleep problems co-occur with crying, eating problems, and parental distress. This study investigates the impact of a parent-focused intervention to improve child sleep with the following aims: (1) To assess the impact on child sleep (sleep onset latency, frequency and duration of nighttime awakenings, frequency of bed-sharing, and nighttime food intake, total nighttime sleep duration, and sleep efficiency), child crying (frequency of crying episodes, of unexplained and unsoothable crying and of crying out of defiance), child eating difficulties, and parental distress of mothers and fathers. (2) To assess the maintenance of any changes in these areas longitudinally, at 3-month, 6-month, and 12-month follow-ups. (3) To explore at the within-subjects level, how children’s sleep, crying, eating, and parental distress changed together across all study measurement points. Methods In this single-arm pilot study, the parents of 60 children participated in six individual sessions of a parent-focused multimodal age-adjusted cognitive-behavioral intervention to improve child sleep. Parents of 39 children (46% girls, age in months M = 22.41, SD = 12.43) completed pre- and at least one measure after the intervention. Sleep diary, questionnaire for crying, feeding, sleeping, and parental stress index (short-form) were assessed pre, post, three, six, and 12 months after the intervention. Results Significantly, sleep (decreased sleep onset latency, frequency, duration of nighttime awakenings, bed-sharing, nighttime food intake; increased total nighttime sleep duration, sleep efficiency), crying (reduced frequency of crying episodes, unexplained and unsoothable crying), and parental distress (reduced) changed, which remained partially stable over follow-up. The frequency of crying episodes decreased with fewer nighttime awakenings; morning crying with increased nighttime feeding; unexplained and unsoothable crying with higher sleep efficiency; crying due to defiance with more nighttime awakenings, sleep efficiency, and bed-sharing. Eating problems decreased with shorter night awakenings and time; maternal distress with fewer nighttime awakenings, paternal with less child’s nighttime feeding, unexplained and unsoothable crying, and time. Conclusions A parental sleep intervention for sleep-disturbed young children could be promising to reduce children’s sleep problems, crying, eating problems and parental distress. Future studies should consider more personal contact during the follow-up to reduce the drop-out rate and a randomized-controlled design. Trial registration The study was retrospectively registered at the German Clinical Trials Register (ID: DRKS00028578, registration date: 21.03.2022).

Can a parental sleep intervention in an individual setting improve the maternal and paternal sense of competence and parent–child interaction in parents of young sleep-disturbed children? findings from a single-arm pilot intervention study

“…The six sessions include: (1) psychoeducation on the child’s sleep; (2) parenting behavior and sleep hygiene; (3) child crying and defiant behaviors; (4) parent and child stress and relaxation; (5) feelings of anxiety and security; and (6) relapse risk and summary 45 . The Mini-KiSS sleep training might be effective on children’s sleep and sleep-related parenting strategies [ 47 , 58 − 60 ].…”

“…However, because of several limitations, the findings should be interpreted with caution. First, the analyses include a small sample characterized by a substantial attrition rate; a detailed analysis of the sample attrition with recommendations for future studies can be found elsewhere 60 . Second, the study design did not include any comparison to a control group, therefore the study findings cannot be interpreted as direct effects of the intervention.…”

“…The parents answered questions on children's ♣ More than two nighttime awakenings if the child was between 12 and 23 months old or more than one if the child was older than 24 months ♣ More than 20 min awake during the night crying and eating during a typical week on a four-point scale (1, never/seldom; 4, always/daily), with high values indicating more difficulties. We referred to seven items concerning crying as the following factors [60]: frequency of crying episodes (FRQ: four items), unexplained and unsoothable crying (UUC: two items) and crying out of defiance (DEF: one item, including early defiance, which helps the child to regulate tension and is not intentional, and later intentional defiance [63]). Problematic eating behavior was assessed with the feeding subscale (EAT: 13 items).…”