Quality of Preterm Infants’ Night Sleep: and Online Community-Based Survey of Maternal Factors and Perceptions of Infants’ Nighttime Awakenings and Sleep Problems

Abstract

Background: Between one-quarter and one-third of infants aged six months to five years have sleeping problems. Infants' night sleep patterns, in particular problematic night waking with crying, are a common concern for parents. Many factors can influence the development of infants’ night sleep patterns and sleep problems, including parental interaction. Objectives: To examine the associations between premature infants’ nighttime awakening, mothers’ reports of sleep problem severity, and maternal factors, including mothers’ styles of attachment and behaviors used to settle their infants to sleep. Method: The cross sectional survey study used a web-based questionnaire to collect data from a community-based sample of 105 mothers of singleton premature infants aged 5-6 months (corrected age) across a number of English speaking countries. The main outcome measures were mothers’ perceptions of infants’ nighttime awakenings (frequency and duration) and presence of infant sleep problems. Results: Of the 55% of mothers who reported that their infants had sleep problems, 17% described the problem as serious. The majority of infants woke 2.1 times per night for an average of 45.7 minutes per night. Mothers’ style of attachment and personal history of sleep problems predicted the duration of the infants’ nighttime awakening, whereas maternal active physical comforting predicted the frequency of nighttime awakenings. Conclusions: The findings can guide healthcare providers to screen mothers for an anxious style of attachment, perceptions of infant sleep problems, and use of active physical comforting strategies for bedtime settling when assessing premature infants’ sleep problems. Keywords: Maternal Attachment, Nighttime Awakenings, Premature Infant, Settling Strategies, Sleep Problem

Sleep Quality of Mothers of Premature Infants after Neonatal Intensive Care Unit Discharge

“…Infants' sleep patterns are problematic and include night waking with crying, a common concern for parents of infants. In previous studies, the mean frequency of nocturnal waking of full-term infants was 0.8/night (range, 0-2.9/night); just over half (55%) of the participating mothers reported that their premature infants woke 2.1 times per night for a mean 45.7 minutes per night, which is similar to our findings [29,30]. We found that the frequency and duration of night wakings of premature infants affected the quality of the maternal sleep.…”

Bedtime Rituals and Routines of Turkish Children and Perceptions of Their Mothers

“…For this reason, training regarding safety measures may be particularly useful in this situation because of the risk of rocking the baby too fast on the mother's legs or causing the baby to fall when the mother is rocking him/her. The children in this study has frequent awakinings as expected (15,26). According to this study 40.5% of children 1-2 times, and 34.0 of children 3-4 times wake up overnight.…”

“…A study with 0-3 years old children, conducted in our country, reported sleep problems at 18.8% (14). The majority of the mothers who participated in another study reported that they considered their babies to have sleep problems and that the problem was serious (15). In another study, 17.33% of mothers from predominantly Asian countries reported severe sleep problems, and 34.57% reported minor sleep problems.…”

“…Teng et al (13) reported that children woke up 1.08 times per night, and the children's total sleep time was 13.24 hours (13). Ali et al (15) observed that infants woke up at least two times per night and fell back to sleep because of their mothers' physically active settling practices. According to result of this study, mother's behaviors of re-settling the child when the child wakes at night are most in 0-4 months feeding/breastfeeding, in 20-24 months waiting for the child to sleep on his/her own, in 5-9 months rocking/carrying in arms and in 20-24 months rocking on legs or cradling.…”

A Proposed Nursing Theory: Infant Sleep and Development

“…An infant’s individual needs relating to sleep may be influenced by his or her genetics (Fisher, van Jaarsveld, Llewellyn, & Wardle, 2012), birth weight, preterm birth (Asaka & Takada, 2010), and chronological age (Galland et al, 2012). Over half of mothers of preterm infants consider their infant’s sleep to be problematic at 5 to 6 months of age (Ali, Hall, Warnock, Wong, & Ratner, 2014). Meanwhile, a caregiver’s interactions with the infant and ability to optimally meet the child’s unique needs may be influenced by separation anxiety (Scher, 2008) and the parent’s own attachment status (Benoit, Zeanah, Boucher, & Minde, 1992), as well as parental age and education level (Oxford & Findlay, 2013).…”