Michal Kahn, Natalie Barnett, Michael Gradisar.
Presented at World Sleep 2022 Symposium.
Behavioral sleep interventions (BSIs) for infants are ubiquitous, yet knowledge about their implementation in real-world settings is limited. This study aimed to compare the frequency, timing, duration, difficulty, and helpfulness of real-world implementation of three BSI approaches: Unmodified Extinction, Modified Extinction, and Parental Presence. It additionally aimed to compare infant sleep, parent sleep, daytime sleepiness, depression, and parent-infant bonding between parents who had and had not implemented these interventions.
Participants were 2090 parents of US infants (49% girls) aged 3-18 months (M=9.1, SD=4.1). Parents completed online questionnaires regarding their infant's sleep, their own sleep quality, daytime sleepiness, depression levels, and parent-infant bonding. Infant sleep was assessed objectively via auto-videosomnography, obtained from the 14-day period prior to survey completion.
Implementation of BSIs was common, with 63.8% of parents reporting implementation of at least one BSI. The average infant age at the time of intervention was 5.3 months (SD=2.6) and did not differ between groups. Unmodified and Modified Extinction were rated as significantly more difficult to implement compared to Parental Presence but also as more helpful, shorter, and quicker to show improvements. Auto-videosomnography revealed that infant nighttime sleep was longer and more consolidated in the Unmodified and Modified Extinction groups compared to the Parental Presence and no BSI groups. Finally, no differences were found between BSI groups in any of the parent measures.
Implementation of BSIs outside clinical settings is pervasive, and occurs earlier than generally recommended by clinicians (i.e., <6 months). Implementation of Unmodified and Modified Extinction was associated with longer and more consolidated infant sleep. Despite concerns regarding the potential harm of BSIs, implementation of these approaches was not linked with parent sleep, daytime sleepiness, depression, or parent-infant bonding, providing additional evidence for the safety and potential benefits of these interventions.
About the Researchers
The researchers included Michal Kahn, Natalie Barnett, 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.