Implementation and Effects of an Online Intervention Designed to Promote Sleep During Early Infancy: A Randomized Trial.

Objective: Examine the implementation and effects of an interactive online intervention designed to support new parents with their young infants' sleep.

Design: First-time parents were enrolled when infants were ~6 weeks old and randomized to a sleep intervention or general baby care control group, with intervention content provided weekly between infant ages 2 to 4 months, primarily as brief videos and infographics in private online groups.

Methods: Parents (n=74) completed online surveys at baseline (infant age ~6 weeks), midpoint (3 months), post-intervention (4 months), and follow-up (7 months), reporting on infant sleep duration and night wakings (via Brief Infant Sleep Questionnaire), as well as their own sleep duration (via Pittsburgh Sleep Quality Index), and parenting satisfaction and self-efficacy (via Perceived Sense of Competence Scale). Marginal models examined sleep intervention effects on infants' total and nightly sleep duration and night wakings, parent sleep duration, and parenting satisfaction and self-efficacy over time.

Results: Eighty-one percent of parents joined the online groups. There was a group-by-time interaction predicting total infant sleep duration, with total sleep increasing in the intervention group relative to controls. Tests of least squares means showed that intervention group infants slept 1.4 hours longer than controls at age 4 months (p=0.004). There were no significant effects on infants' nighttime sleep, but daytime napping increased in the intervention group relative to controls (p=0.04). Group differences in parent sleep were not statistically significant but were in a consistent direction when compared with intervention impacts on infant sleep. Parenting satisfaction increased significantly in both groups.

Conclusion: Findings demonstrate the potential of an interactive online sleep intervention to support first-time parents with early infant sleep. Parent perspectives support acceptability of the approach and highlight the potential for further development of this scalable online intervention and examination of its impacts on additional aspects of well-being.

Clinical trial registration: The study was registered prior to participant enrollment at clinicaltrials.gov (NCT05322174). URL: https://clinicaltrials.gov/study/NCT05322174.