Sleep in the Family

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Pregnancy, neonates, and infants

Hormonal changes contribute to alterations in maternal sleep as early as the first trimester,2 resulting in less total sleep, lower sleep efficiency, more frequent night wakings, and less deep sleep than before pregnancy.3, 4 However, sleep is most disrupted in the immediate postpartum period. Compared with pregnancy, the postpartum period is characterized by a self-report of 3 times the number of nighttime awakenings, a decrease in sleep efficiency, and twice the level of daytime sleepiness.5

Toddlers, preschoolers, and school-aged children

A national survey of sleep in American children reported more than 50% of parents losing an average of 30 minutes of sleep per night because of their child’s night awakenings.40 The negative association between child sleep disruptions and parent sleep and health has also been reported in population studies of Australian preschoolers and Swedish school children. Sleep problems in Australian children were associated with psychological distress among mothers and poor general health among both

Adolescents

In general, adolescents in the United States are sleep deprived, averaging only 7.6 hours, considerably less than the required 9.2 hours.54, 55 This sleep deprivation is primarily caused by academic and social demands that result in late bedtimes and early wake times, as well as a circadian shift in the underlying biologic clock. This shortened sleep opportunity may also influence parent sleep, although few studies have examined this issue. For example, parents may have difficulties initiating

Chronic illness

A chronic illness affects family functioning in many ways, including sleep disruptions for both children and caregivers. Sleep problems among children can be caused by disease symptoms (eg, pain, itching, wheezing) or medical management of the disease (eg, nocturnal blood glucose monitoring).61, 62, 63, 64, 65, 66, 67 Parent sleep may be disrupted because of heightened vigilance (eg, monitoring for a seizure), worries about the child’s health, or changes to sleeping arrangements (eg, increased

Developmental disorders

For children with developmental disorders (including intellectual disabilities, autism spectrum disorder [ASD], and attention-deficit/hyperactivity disorder [ADHD]), sleep problems are common and can include difficulties initiating sleep, frequent and/or prolonged night waking, as well as early morning sleep termination.79, 80, 81, 82, 83, 84 Because many of these children cannot go unsupervised, if the child is not sleeping, parents are typically also not sleeping.

Multiple studies have found

Summary

Because the family system is a central part of a child’s life, child sleep problems can have a significant impact on family functioning, in particular parent sleep and daytime functioning (eg, mood, stress, and marital satisfaction). Likewise, family functioning (eg, parent stress, marital conflict) may affect child sleep. Behavioral treatments that improve sleep in children are also likely to result in improvements to parental sleep and subsequent daytime functioning, although more research is

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    This work was supported by grant no. MH077662 from the National Institutes of Health.

    The authors have nothing to disclose.

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