Meg Pillion, Michal Kahn, Natalie Barnett, Assaf Glazer, Tor Ivry, Michael Gradisar
Presented at the conference of the World Sleep Congress in Vancouver in September 2019
Sleep problems are prevalent in 20-30% of infants. While some research has investigated the detrimental effects of poor sleep in infants (e.g., emotional and behavioural problems), less is known about the consequences for parents of poor sleeping infants. There is emerging evidence to suggest that poor sleep in infants is negatively associated with parents’ sleep quality and mental health, however the implications for daytime functioning (e.g., driving, social and occupational performance) in this population of parents is under researched. Using the novel Nanit camera sleep tracking system and algorithm to objectively measure infant sleep, this study aimed to investigate the subjective daytime dysfunction in parents of infants with and without a sleep problem.
Materials and methods
A total of 619 families (52% infant boys; Mage=37.8 weeks, SD=17.3, range= 10-142 weeks) participated in this cross-sectional study. Infant sleep quality was objectively measured in the infant’s naturalistic setting using the Nanit camera system, and automatically analysed using its computer vision algorithm. Sleep metrics were averaged for each infant across 14 consecutive nights. The Brief Infant Sleep Questionnaire was used to assess the presence of infant sleep problems as reported by parents. Daytime dysfunction was measured using the corresponding sub component (component 7) of the Pittsburgh Sleep Quality Index. Both questionnaires were completed by parents online.
Parents who perceived their infant to have a sleep problem were approximately 3 times more likely to report daytime dysfunction (see Table 1, model 1). Objective sleep quality and infant age did not independently predict daytime parental dysfunction. However, infant age moderated the association between infant sleep problems and parental daytime dysfunction (see Table 1, model 2). Path analysis revealed that for parents of infants with a sleep problem, the likelihood of reporting daytime dysfunction increased as infant advanced in age, whereas for parents with infants without a sleep problem, daytime dysfunction was not associated with infant age (see Figure 1).
Table 1. Determinants of parental daytime dysfunction: Logistic regression including infant age, objective sleep quality and reported sleep problems (Model 1), and age by sleep problem interaction (Model 2).
SE; standard error, OR; odd ratio, CI; confidence interval
For reported sleep problems: No sleep problems=0; Sleep problems=1
Infant age was centered at the median (=35 weeks)
*P<.05, ** P<.005
Figure 1. Parental daytime dysfunction as a function of infant age and presence of sleep problems
Parents of infants with sleep problems had a ~3-fold risk of experiencing daytime dysfunction compared to parents of infants without sleep problems. This association was moderated by infant age, as the likelihood of reporting daytime dysfunction for parents of infants with sleep problems increased with age by approximately 14% per month. This increase in daytime dysfunction could be
explained by an accumulative effect of sleep disturbance for parents over time in the first years of their infant’s life. It may alternatively be due to changes in age-related expectations that occur throughout infancy. Future studies should explore these postulations using longitudinal designs and objective measurement of daytime parental dysfunction. The clinical and societal significance of the present findings are of vast importance, given that they identify a distinct population at risk for impaired daytime performance (in driving, as well as social and professional settings), that may affect their physical and mental safety and well-being.
About the researchers
The authors include Meg Pillion, Michal Kahn, Natalie Barnett, Assaf Glazer, Tor Ivry, and Michael Gradisar.
- Dr. Michal Kahn is a sleep researcher and licensed clinical psychologist, specializing in pediatric insomnia and sleep development. She is a senior lecturer (assistant professor) at the School of Psychological Sciences at Tel Aviv University, Israel.
- Dr. Natalie Barnett serves as VP of Clinical Research at Nanit. Natalie initiated sleep research collaborations at Nanit and in her current role, Natalie oversees collaborations with researchers at hospitals and universities around the world who use the Nanit camera to better understand pediatric sleep and leads the internal sleep and development research programs at Nanit. Natalie holds a Ph.D. in Genetics from the University of New England in Australia and a Postgraduate Certificate in Pediatric Sleep Science from the University of Western Australia. Natalie was an Assistant Professor in the Neurogenetics Unit at NYU School of Medicine prior to joining Nanit. Natalie is also the voice of Nanit's science-backed, personalized sleep tips delivered to users throughout their baby's first few years.
- Dr. Michael Gradisar is a Professor and Director and Clinical Psychologist at the Child & Adolescent Sleep Clinic at WINK Sleep in Australia, and the Head of Sleep Science at Sleep Cycle in Sweden. Dr. Gradisar has specialized in the treatment of pediatric sleep problems since 2006. He has provided training to over 420 psychologists throughout Australia on the treatment of pediatric sleep disorders, and published several research studies evaluating the treatment of insomnia and circadian rhythm disorders in children, adolescents and adults. In all, Dr. Gradisar has over 100 publications in peer-reviewed journals, has authored several book chapters, and has presented on sleep-related research and intervention internationally.