Extended tummy time is associated with longer nighttime sleep duration in 4-5 months old infants.

In our study, we investigate whether the amount of tummy time is associated with sleep in infants 4-5 months of age. 
Changes in sleep associated with infant teething from 4-18 months of age Reading Extended tummy time is associated with longer nighttime sleep duration in 4-5 months old infants. 4 minutes Next End of daylight saving and sleep children 4-24 months

Sarah Berger, Maristella Lucchini, Shambhavi Thakur, Natalie Barnett

Presented at Sleep and Breathing, Prague, 2023


Background and objectives

Tummy time (TT) is defined as an infant being placed on their stomach while they are awake and supervised. Parents are encouraged to have their children practice TT because it has been shown to improve motor, cognitive and social development. Despite sleep being critical for optimal development, only a few studies have looked at the association between TT and sleep. A recent study showed that starting TT early (<4 weeks) was associated with better sleep in children at 12-24 months of age. In our study, we investigate whether the amount of TT is associated with sleep in infants 4-5 months of age. 


Our sample included 468 infants, recruited among the Nanit customer base, 57% girls, mean age 4.4±0.5 months. Nanit autovideosomnography metrics indicated that mean sleep duration was 9.2±1.2hr, sleep efficiency 85%±8.3, mean number of awakening 5.5±2.2. We ran generalized estimating equations with sleep duration, number of nighttime awakening and sleep efficiency as outcomes, amount of TT as predictor and child's age and sex as covariates. Results 

Compared to infants who did at least 1 hour/day of TT (N=122), infants who did <10 min (N=36) slept less (β=-0.3±0.2,p=0.05) and had worse sleep efficiency (β=-0.03±0.01,p=0.04), infants who did TT 10-19 min/day (N-72) had worse sleep efficiency (β=-0.03±0.01,p=0.03) and infants who did TT 20-29 min/day (N=121) had shorter sleep duration (β=-0.4±0.2,p=0.02) and more night awakenings (β=0.5±0.2,p=0.007). We did not find significant differences for infants who practiced TT 30-59min/day (N=164). 


More research is warranted to understand underlying pathways of this association, potentially involving energy expenditure and parental competence.

Extended tummy time is associated with longer nighttime sleep duration in 4-5months old infants.

About the Researchers

The researchers included Sarah Berger, Maristella Lucchini, Shambhavi Thakur, and Natalie Barnett.

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  • Dr. Sarah Berger is a Professor of Psychology at the College of Staten Island and the Graduate Center of the City University of New York. She received her PhD from New York University. Dr. Berger was an American Association of University Women Postdoctoral Research Fellow and a Fulbright Research Scholar. Dr. Berger studies the interaction between cognitive and motor development in infancy, particularly response inhibition and its implications for the allocation of attention in very young children. A line of National Science Foundation (NSF)-funded work, in collaboration with Dr. Anat Scher, has been the first to study the impact of sleep on motor problem solving in infancy.
  • Dr. Maristella Lucchini serves as Senior Clinical Researcher at Nanit. In her role, Maristella works to secure grant funding in collaboration with Nanit’s university research partners and supports the development of the company’s  research collaborations around the world. Previously, Maristella served as an Assistant Research Scientist in the Division of Developmental Neuroscience, Department of Psychiatry at Columbia University Irving Medical Center where she led projects across several cohorts focusing on sleep health for pregnant and postpartum women and their children. Maristella’s research focused on underserved communities and sleep health disparities in the perinatal period. During her years as a postdoctoral researcher at Columbia University Irving Medical Center in the Department of Psychiatry, Maristella was selected to participate in the American Academy of Sleep Medicine Young Investigator Research Forum. She holds a Ph.D. in Biomedical Engineering from Politecnico di Milano. 

  • Shambhavi Thakur serves as Clinical Research Data Analyst at Nanit. She holds a Masters degree in Health Informatics and Life Sciences. She oversees the research collaborations with various universities and analyzes sleep data for internal as well as external studies.

  • 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.

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