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Sleep in Early Childhood
Published in Mary Nolan, Shona Gore, Contemporary Issues in Perinatal Education, 2023
Angela D. Staples, Leah LaLonde
This review does not address sleep disorders such as sleep apnea, in part because treatment is primarily the domain of physicians. Additionally, this review does not address specific socio-cultural factors such as co-sleeping, feeding practices, or environmental factors (e.g., tobacco use, neighborhood noise, type of bedding) – all of which impact both parent and child sleep. Instead, we provide a selective overview of four interrelated topics regarding sleep in early childhood with a specific emphasis on behavioral interventions for sleep problems. First, we briefly review the typical changes in sleep from birth through age three. Second, we highlight parenting practices in relation to child development and cultural context. Third, we summarize effective sleep interventions for young children. Finally, we emphasize the role of the bedtime routine as a relatively straightforward practice that, when implemented early, may prevent the development of sleep problems.
Behavioural Sleep Problems in Children and Adolescents
Published in Cathy Laver-Bradbury, Margaret J.J. Thompson, Christopher Gale, Christine M. Hooper, Child and Adolescent Mental Health, 2021
For some families, co-sleeping, where the child shares the parental bed, is a positive choice and part of normal routine. It is not advised in infancy because of the risk of sudden infant death. In older children, co-sleeping is associated with sleep difficulties when it is used as a ‘fall back’, because the child will not sleep in their own bed. The parental bed is the greatest ‘reward’ of all for many children. Exhausted parents who relent and allow the child to co-sleep during the night have undone all the hard work they have put in earlier in the evening teaching a child to settle to sleep. When a child creeps in silently whilst parents are sleeping, practical measures, e.g. a bell on the door, can alert the parent so that they can return the child to their own bed.
Integrating primal wisdom with the modern Western worldview
Published in Antonella Sansone, Cultivating Mindfulness to Raise Children Who Thrive, 2020
Primal wisdom cultures teach us that constant affectionate physical contact with a baby is critically important for a child’s healthy development. Scientists have known this for decades. How often an infant is touched and held and the related feeling of connection and being felt can leave lasting effects not just on behaviour and growth, but all the way down to the molecular level of the DNA (Moore et al., 2017). The pleasurable experience affects the epigenome – the biochemical changes that influence gene expression in the body. This underscores the importance of feeling connected through physical contact, especially for distressed infants. The potential physiological benefits to infants sleeping in proximity to their caregivers, especially in the first year of life, and to breastfeeding, so biologically entwined to co-sleeping, have been described (McKenna et al., 1994; McKenna & Bernshaw, 2017). Breastfeeding and infant-parent co-sleeping have been both designed for adaptation by natural selection over millions of years of human evolution. Because human infants are born neurologically immature, develop slowly and remain dependent for a long period of time, continuous contact and proximity to the mother served to maximise the chances of infant survival and thus parental reproductive success (Konner, 2005). Feeling connected is hence a human biological necessity.
Direct assessment of overnight parent-child proximity in children with behavioral insomnia: Extending models of operant and classical conditioning
Published in Behavioral Sleep Medicine, 2023
Georgie Agar, Chris Oliver, Caroline Richards
Four of nineteen parent-child triads were classified as “co-sleeping”, indicated by extended periods at closer proximity, often with both parents. This typically began following a period of actigraphy-defined wake and continued into a period of sleep. Children in this group had a trend toward poorer sleep parameters, and significantly poorer sleep hygiene, than children in the “no proximity” group. Most parents classified as “co-sleeping” reported that their child insists on sleeping with someone else “a few times a month – daily”, and that they only return their child to their own bed after waking “sometimes”. This supports the pattern identified through visual inspection where co-sleeping occurred on just one night in each child’s study week, and suggests a different intervention approach may be needed. Though parents in this classification group may benefit from using extinction techniques to return their child to their own bed (Weiskop et al., 2005), given that all the children in this group have SMS, co-sleeping may have been deemed necessary by parents to keep their children safe (Agar et al., 2022). Therefore, other strategies to monitor children’s safety such as a camera in the child’s bedroom, or alarm systems to notify parents when their child leaves the room, may be more beneficial to families in this classification group.
Sleep and asthma management in youth with poorly-controlled asthma and their caregivers: a qualitative approach
Published in Journal of Asthma, 2022
Corinne Evans, Andrea Fidler, Dawn Baker, Mary Wagner, David Fedele
Consistent with extant literature, caregivers of adolescents with poorly-controlled asthma described experiencing frequent sleep disturbances and feelings of fear or anxiety regarding their child’s nocturnal asthma (20). Some caregivers made substantial sacrifices to manage their child’s nocturnal asthma. For example, one caregiver reported co-sleeping with her child as a mechanism for symptom monitoring. Although co-sleeping is associated with sleep disruption in school-age children, less is known about the impact of co-sleeping on adolescents (32). Co-sleeping is also more prevalent within certain cultures (33). Previous research suggests a negative relationship between caregiver QOL and youth (children and adolescents) nocturnal asthma symptoms; as youth nocturnal asthma symptoms increase, caregiver QOL tends to decrease (34–36). Caregiver responses from the current study are congruent with previous findings and demonstrate that caregivers can experience a high level of burden associated with their child’s asthma-related sleep disturbances.
Neighborhood Socio-Economic Factors and Associations with Infant Sleep Health
Published in Behavioral Sleep Medicine, 2021
Anna L. MacKinnon, Lianne Tomfohr-Madsen, Suzanne Tough
Important to note is the role of parental behaviors and bedtime or sleep-related practices from our findings. Across all models, longer breastfeeding duration and co-sleeping predicted worse sleep outcomes for infants at 12 months. This finding is consistent with previous research showing that breastfeeding and co-sleeping are associated with shorter sleep duration, more awakenings, and longer sleep onset latency in infants (Galbally et al., 2013; Mao et al., 2004; Mindell et al., 2010). Although 1.4% of participants reported stopping breastfeeding after 12 months postpartum, previous breastfeeding may have contributed to infant sleep patterns that persist. More specifically, it may be parental presence at bedtime (vs. falling asleep independently) and breastfeeding back to sleep that lead to problems with self-soothing and sleep consolidation (Mindell et al., 2010). There is a large body of evidence on which parental behaviors and sleep-related practices (e.g., early bedtime, consistent routine) significantly improve infant and child sleep (Mindell & Williamson, 2018). Parents and healthcare providers should consider risks and benefits of different bedtime practices in conjunction with preferences and cultural beliefs in order to find what best meets families’ needs.