Maternal Depressive Symptoms and Toddler Sleep: Moderating Effects of Sleep Parenting Practices.

Abstract

Background and aims: Toddler sleep is more consolidated than infant sleep and may better reflect long-term sleep regulation. Despite growing interest in maternal mental health, evidence linking maternal depression to toddler sleep remains limited. Moreover, sleep parenting practices may shape this relationship. This study aimed to examine the status of maternal depression, toddler sleep, and sleep parenting practices, as well as the moderating role of these practices in the association between maternal depression and toddler sleep.

Methods: This research employed a cross-sectional design conducted between November 2022 and March 2023 among mothers of toddlers in Taiwan. A total of 126 mothers of toddlers aged 1 to 3 years completed an online survey. The mean age of mothers was 33.01 years (SD = 4.33), and the mean age of toddlers was 1.79 years (SD = 0.58). Maternal depression was assessed using the Beck Depression Inventory-II (BDI-II, Beck, 1996). Toddler sleep was measured using the Brief Infant Sleep Questionnaire-Reviesd (Mindell et al, 2019), including four indicators: maternal perceived sleep problem, sleep latency, number of nocturnal awakenings, and nighttime sleep duration. Two sleep parenting practices were assessed: co-sleeping (co-sleep vs not co-sleep) and consistency of sleep routines. Data were analyzed using descriptive statistics, group comparisons, correlation analyses, and multiple regression analyses.

Results: Approximately 33.3% of mothers exhibited depressive tendencies (BDI-II > 13). Most toddlers had nighttime sleep duration shorter than 12 hours (91.3%). Around half of the toddlers had sleep latency longer than 45 minutes (50.8%), 34.9% experienced at least two nocturnal awakenings, and 11.9% were reported to have sleep problem. Co-sleep was reported by 51.6% of mothers, and 45.2% had low consistency in their sleep routines (≤5 nights/week). After controlling for child health status, maternal income, and education level, higher maternal depressive symptoms were associated with greater toddler sleep problem severity and longer sleep latency (Bs = 0.02 and 0.87, ps < 0.05 and 0.01, respectively). Co-sleep moderated the association between maternal depression and toddler sleep problem (B = -0.05, p < 0.05). Simple slope analyses indicated that higher maternal depression was associated with more severe toddler sleep problem in the co-sleep group (B = 0.05, p < 0.01), but not in the not co-sleep group (B = 0.00, p > 0.05). No moderating effect was found for sleep routine consistency.

Conclusion: Maternal depression is associated with more severe sleep problem and longer sleep latency in toddlers. Co-sleep may amplify the spillover associations of maternal depression on toddler sleep. For mothers with elevated depressive symptoms, encouraging separate sleeping arrangements may help buffer the association between maternal depression and maternal perceived toddler sleep problem. Further studies to validate these findings are warranted.