Sleep health in the family Context: Predictors and qualitative exploration of parentally perceived early childhood insomnia

Abstract

Background

Early childhood sleep problems are associated with adverse parental outcomes. Limited research has examined parentally perceived early childhood insomnia (ECI) using a family sleep health framework. This mixed-method study investigated the predictors of parent-reported ECI, fusing a family sleep health framework.

Methods

Infants aged 6–36 months with and without sleep problems and their parents were included based on a convenience sample. Infant sleep was evaluated by Brief Infant Sleep Questionnaire (BISQ) and actigraphy. Parents were assessed for mental health symptoms, sleep characteristics and in-depth interviews were conducted to explore parental perception of infant sleep. Logistic regression was used to identify predictors of parentally perceived ECI, and thematic analysis was applied to qualitative data.

Results

41 families with ECI and 45 without ECI were included. According to the BISQ, infants with ECI had longer sleep onset time and wakefulness after sleep onset, more frequent night awakenings and shorter total sleep duration (p < 0.01). Actigraphy data revealed no significant differences except for later bedtimes and wake times in the control group. Mothers in the ECI group had higher depression and anxiety scores (p < 0.01), and fathers had higher anxiety scores (p = 0.048). After controlling for parental mental health, higher number of infant night awakenings, maternal daytime dysfunction and paternal subjective sleep quality were predicting parentally perceived ECI. Qualitative data revealed that parental emotional adaptation and expectations shaped the perception of sleep problems.

Conclusion

Parentally perceived ECI has impacts on the whole family sleep health, associated prominently with reduced infant nocturnal sleep continuity, increased maternal daytime dysfunction and poorer paternal sleep quality.