0767 INSIGHT Responsive Infant Parenting Intervention and Child Sleep at Age 6 Years

Abstract

Abstract Introduction The Intervention Nurses Start Infants Growing on Healthy Trajectories (INSIGHT) responsive parenting (RP) intervention for first-time mothers resulted in more responsive bedtime parenting and longer infant sleep duration in the first year after birth. The current analysis evaluates intervention effects on parent-reported sleep behaviors and objectively-measured sleep at child age 6 years. Methods Mothers (n=279) were randomized to the RP or control intervention, delivered by nurses at home and clinic visits through child age 2.5 years. Sleep content focused on establishing bedtime routines, age-appropriate bedtimes, and promoting self-soothing at bedtime and after night wakings. At 6 years, children completed wrist actigraphy (Spectrum Plus) for 7 days during the school year. Children with ≥3 valid days were included in analyses (n=162). Mothers (n=173) completed the Children’s Sleep Wake Scale and Children’s Sleep Hygiene Scale. Study group differences for 10 sleep actigraphy variables (M/SD of onset, offset, and midpoint of sleep timing, sleep maintenance efficiency, and total sleep time), as well as survey scores, were examined. Results Children (mean age 6.7 years, 96% non-Hispanic White) slept on average 8.8 hours ± 33 minutes per night, with 40% meeting the minimum recommendation of 9 hours. The mean sleep onset time was 9:14 pm ± 50 minutes. There were no significant study group differences in any actigraphy variables. RP mothers reported higher scores for Total Sleep Quality (4.6 ± 0.5 vs. 4.4 ± 0.6, p=0.03), ‘Going to Bed’ subscale (4.3 ± 0.8 vs. 4.0 ± 0.9, p=0.03), which captures child compliance with bedtime, and ‘Reinitiating Sleep’ subscale (4.6 ± 0.9 vs. 4.2 ± 1.1, p=0.005), which captures the child’s ability to go back to sleep on their own after waking. Total Sleep Hygiene score did not differ between groups. Conclusion The INSIGHT intervention targeting sleep in infancy was associated with improved parental perception of bedtime stalling and self-soothing behaviors at age 6 years. However, this did not translate into differences in sleep duration, timing, or quality measured by actigraphy. Future research should examine strategies to maintain the impacts of the RP intervention on infant sleep into middle childhood. Support (if any) R01DK088244, KL2TR002015