Sleep in the Family
Section snippets
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
References (93)
- et al.
Parity and sleep patterns during and after pregnancy
Obstet Gynecol
(2000) - et al.
A selective review of maternal sleep characteristics in the postpartum period
J Obstet Gynecol Neonatal Nurs
(2009) - et al.
Normative longitudinal maternal sleep: the first 4 postpartum months
Am J Obstet Gynecol
(2010) - et al.
Mood changes in the first three weeks after childbirth
J Affect Disord
(1981) - et al.
A prospective study of sleep, mood, and cognitive function in postpartum and nonpostpartum women
Obstet Gynecol
(1997) - et al.
Effects of pregnancy on mothers’ sleep
Sleep Med
(2002) - et al.
Sleep patterns and fatigue in parents of twins
J Obstet Gynecol Neonatal Nurs
(2008) - et al.
Night waking in 6-month-old infants and maternal depressive symptoms
J Appl Dev Psychol
(2007) - et al.
The role of cognitive-behavioral therapy in behavioral childhood insomnia
Sleep Med
(2010) - et al.
Evidence for similarities between adolescents and parents in sleep patterns
Sleep Med
(2009)
Epidemiologic study of sleep quality and troubles in French secondary school adolescents
J Adolesc Health
Sleep quality and depression-anxiety in mothers of children with two chronic respiratory diseases: asthma and cystic fibrosis
J Cyst Fibros
The relationship between home nursing coverage, sleep, and daytime functioning in parents of ventilator-assisted children
J Pediatr Nurs
Sleep quality and psychological wellbeing in mothers of children with developmental disabilities
Res Dev Disabil
Factors associated with depressive symptoms in parents of children with autism spectrum disorders
Research in Autism Spectrum Disorders
Considering sleep in a family context: introduction to the special issue
J Fam Psychol
Sleep patterns and fatigue in new mothers and fathers
Biol Res Nurs
Longitudinal study for sleep-wake behaviours of mothers from pre-partum to post-partum using actigraph and sleep logs
Psychiatry Clin Neurosci
Changes in sleep patterns of young women from late pregnancy to postpartum: relationships to their infants’ movements
Percept Mot Skills
Mothers’ wakefulness at night in the post-partum period is related to their infants’ circadian sleep-wake rhythm
Psychiatry Clin Neurosci
Sleep and wakefulness
Negotiating sleep: a qualitative study of new mothers
J Perinat Neonatal Nurs
Detection of postnatal depression. Development of the 10-item Edinburgh Postnatal Depression Scale
Br J Psychiatry
Relationships among infant sleep patterns, maternal fatigue, and development of depressive symptomatology
Birth
Maternal sleep-related cognitions and infant sleep: a longitudinal study from pregnancy through the 1st year
Child Dev
Couples’ experiences with fatigue during the transition to parenthood
J Fam Nurs
Infant sleep and parental sleep-related cognitions
J Fam Psychol
Infant sleep and paternal involvement in infant caregiving during the first 6 months of life
J Pediatr Psychol
Childhood sleep problems: association with prenatal factors and maternal distress/depression
J Paediatr Child Health
Maternal well-being and sleep- wake behaviors in infants: an intervention using maternal odor
Infant Ment Health J
Infant sleep problems and postnatal depression: a community-based study
Pediatrics
Outcomes of infant sleep problems: a longitudinal study of sleep, behavior, and maternal well-being
J Pediatr
Sleep problems in young infants and maternal mental and physical health
J Paediatr Child Health
The role of attachment security, temperament, maternal perception, and care-giving behavior in persistent infant sleeping problems
Infant Ment Health J
Adverse associations of infant and child sleep problems and parent health: an Australian population study
Pediatrics
Behavioral treatment of bedtime problems and night wakings in infants and young children
Sleep
A longitudinal follow-up study of young children’s sleep patterns using a developmental classification system
Behav Sleep Med
A behavioral-educational intervention to promote maternal and infant sleep: a pilot randomized, controlled trial
Sleep
Effects of parent training on infant sleeping patterns, parents’ stress, and perceived parental competence
J Consult Clin Psychol
Preventing sleep problems in infants: a randomized controlled trial
J Adv Nurs
Use of a behavioural programme in the first 3 months to prevent infant crying and sleeping problems
J Paediatr Child Health
Treatment of sleep problems in families with young children: effects of treatment on family well-being
Acta Paediatr
Effects on parents of an intervention to resolve infant behavioral sleep problems
Pediatr Nurs
Long-term mother and child mental health effects of a population-based infant sleep intervention: cluster-randomized, controlled trial
Pediatrics
Randomised controlled trial of behavioural infant sleep intervention to improve infant sleep and maternal mood
Br Med J
Evaluating a family-centred intervention for infant sleep problems
J Adv Nurs
Cited by (0)
This work was supported by grant no. MH077662 from the National Institutes of Health.
The authors have nothing to disclose.