Trajectories and Predictors of Nocturnal Awakenings and Sleep Duration in Infants

Hysing, Mari; Harvey, Allison G.; Torgersen, Leila; Ystrøm, Eivind; Reichborn‐Kjennerud, Ted; Sivertsen, Børge

doi:10.1097/dbp.0000000000000064

Cited by 107 publications

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“…The overall aim of the present study was to investigate whether specific sleep problems in toddlers are related to both concurrent and subsequent emotional and behavioral problems in preschool children. Two hypotheses were tested: (1) there is a high concomitant occurrence of sleep problems and emotional problems at age 18 months, and (2) both nocturnal awakenings and short sleep duration predict development of later emotional and behavioral problems, also after controlling for internalizing and externalizing problems at age 18 months.…”

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Later Emotional and Behavioral Problems Associated With Sleep Problems in Toddlers

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IMPORTANCE Childhood sleep problems have been linked to a range of adverse health outcomes, but there is limited knowledge as to the temporal association between sleep problems and subsequent emotional and behavioral problems in young children. OBJECTIVE To examine whether sleep problems in toddlers aged 18 months are related to both concurrent and subsequent emotional and behavioral problems in preschool children aged 5 years. DESIGN, SETTING, AND PARTICIPANTS A large population-based longitudinal study was conducted in September 2014 using data from the Norwegian Mother and Child Cohort Study conducted at the Norwegian Institute of Public Health from June 1, 1999, to December 31, 2008. A total of 32 662 children or pregnancies were included. EXPOSURES Sleep was assessed by mother-reported child sleep duration and nocturnal awakenings. MAIN OUTCOMES AND MEASURESEmotional and behavioral problems were measured with items from the Child Behavior Checklist and operationalized according to recommended clinical cutoffs, corresponding to T scores of greater than 65 (93rd percentile). Risk ratios (RRs) were calculated using negative binomial regression, controlling for emotional and behavioral problems at 18 months and other relevant covariates.RESULTS Short sleep duration (Յ10 hours) in 556 children (1.7%) and frequent nocturnal awakenings (Ն3 times) in 1033 children (3.2%) at 18 months significantly predicted both concurrent and later incidence of emotional and behavioral problems at 5 years. The longitudinal RRs were generally larger for internalizing problems, with adjusted RRs of 1.59 (95% CI, 1.23-2.08) for both short sleep duration and 1.57 (95% CI, 1.28-1.93) for nocturnal awakenings; RRs for externalizing problems were 1.77 (95% CI, 1.37-2.30) and 1.25 (95% CI, 1.00-1.58), respectively. Additional adjustment for emotional and behavioral problems at 18 months slightly reduced the strength of these associations, and all RRs remained significant in the fully adjusted models. CONCLUSIONS AND RELEVANCEEarly sleep problems predict later development of emotional and behavioral problems. Intervention studies are needed to examine whether sleep programs targeting early childhood may avert the onset of later adverse outcomes.

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Later Emotional and Behavioral Problems Associated With Sleep Problems in Toddlers

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“…For example, infant-cued feeding in the first postnatal weeks is generally agreed to be beneficial in establishing lactation and maintaining breastfeeding. However, when continued past the early months, infant-cued parenting that includes high proximity, rapid responses and, in some cases, bed-sharing, is associated with persistence of night-time waking and crying past the age when most infants start to ‘sleep through the night’ [43,46]. This phenomenon, often referred to as an ‘infant sleep problem’, is a source of distress for many parents and a substantial cost for health services.…”

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Parenting the crying infant

Zeifman

James‐Roberts

2017

Current Opinion in Psychology

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Crying conveys evidence about an infant’s state and neurological health which, when carefully assessed, can provide diagnostic information for parents and clinicians. When crying is inconsolable or judged to be excessive, it can stress parents, disrupt parenting and, in rare cases, place an infant at risk for abuse. Research has revealed physiological and neural responses to crying that may predispose some adults to maltreat infants. Although this work suggests that parental vulnerabilities contribute to insensitive or aggressive reactions, there is a growing recognition that exposure to large doses of crying may be a challenge for all adults. Support programmes that inform parents about infant crying, enhance parenting, and improve parental wellbeing and coping, are under development with promising initial findings.

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“…Dette funnet er interessant å sammenholde med resultater fra den store norske mor-og-barn-studien, som viste at amming ved seks måneders alder var assosiert med nattlig oppvåkning, men ikke predikerte søvnvansker ett år senere. Samsoving ble fremhevet som en selvstendig prediktor for nattlig oppvåkning (27). Det kan tenkes at fullamming oftere fører til oppvåkning på grunn av sult når barna blir større og får økt naeringsbehov.…”

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Trajectories and Predictors of Nocturnal Awakenings and Sleep Duration in Infants

Abstract: Considering the chronicity of nocturnal awakening and its association with bedsharing, our findings support current recommendations of reducing bedsharing to improve sleep among infants.

Cited by 107 publications

References 17 publications

Later Emotional and Behavioral Problems Associated With Sleep Problems in Toddlers

Later Emotional and Behavioral Problems Associated With Sleep Problems in Toddlers

Parenting the crying infant

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