Infant Sleep Questionnaire Research Articles

Sleep patterns in 1 to 36 month-old children

Background Better understanding about sleep patterns inIndonesian children can contribute to basic knowledge foreducating parents and health providers about good sleephygiene.Objectives To find out sleep patterns in 1􀁊36 month􀁊oldchildren.Method A descriptive, cross􀁊sectional study was held in EastJakarta on May 2009. Subjects were 1 to 36 months old childrenwho came \\lith their parents or primary caregivers. Data collectionwas performed using modified Brief Infant Sleep Questionnaire(BISQ), consisted of subjects' characteristics, sleep patterns, sleepproblems, and associating factors.Results Among 147 children, sleep problems were identified in33.3% of them. Bedtime was mostly at 8 p.m., wake up time was5 a.m. Median time needed to fall asleep was 20 minutes. Averagefrequency of night waking was twice during one night. Mediannight waking duration was 15 minutes. Median sleep duration atnight was 9 hours 20 minutes, and median nap duration was 2hours 20 minutes. Median total sleep time was 12 hours. Pronesleeping position was significantly associated \\lith sleep problems(p􀁋0.036, RR􀁋1.67, 95%CI􀁋1.66-2.64).Conclusions Prevalence of sleep problem is 33.3%, \\lith awakeningat night was being the most occurring problem. Prone sleepingposition is associated \\lith sleep problems. [Paediatr Indones.2010;50:170-5].

Parental behaviors and sleep outcomes in infants and toddlers: A cross-cultural comparison

Background To assess the prevalence of parental behaviors and other factors of sleep ecology and to analyze their relationships with sleep outcomes in a large sample of children ages birth to 36 months in multiple countries/regions. Methods Parents of 29,287 infants and toddlers (48% boys; Australia, Canada, China, Hong Kong, India, Indonesia, Korea, Japan, Malaysia, New Zealand, Philippines, Singapore, Taiwan, Thailand, United Kingdom, United States, and Vietnam) completed an internet-based expanded version of the Brief Infant Sleep Questionnaire. Results Overall, there is a high level of parental involvement in sleep onset and sleep maintenance for young children, with significant differences in parenting behaviors across cultural groups. For predominantly-Caucasian, the most common behavior occurring at bedtime is falling asleep independently in own crib/bed (57%), compared to just 4% of those children living in predominantly-Asian regions. Parental behaviors and sleep ecology, including parental presence at sleep onset, bedtime, and bedtime routine, significantly explain a portion of the variance in sleep patterns. Overall, parental behaviors are more highly predictive of nighttime sleep outcomes in predominantly-Caucasian regions. Finally, parental involvement in sleep onset mediates the relationship between cosleeping and sleep outcomes. Conclusions Overall, the best predictors of nighttime sleep are related to parental behaviors at bedtime and during the night. Furthermore, sleep disruption and decreased total sleep associated with bed sharing and room sharing are mediated by parental presence at bedtime. These findings provide additional support for addressing parental behaviors in behavioral interventions for infant and toddler sleep problems.

Sleep and physical growth in infants during the first 6 months

The aim of this study was to explore the relationships between infant sleep patterns and infant physical growth (weight for length ratio) using both objective and subjective sleep measures. Ninety-six first-born, healthy 6-month-old infants and their parents participated in the study. Infant sleep was assessed by actigraphy for four consecutive nights and by the Brief Infant Sleep Questionnaire (BISQ). In addition, parents were asked to complete background and developmental questionnaires. Questions about feeding methods were included in the developmental questionnaire. Infants' weight and length were assessed during a standard checkup at the infant-care clinic when the infants were 6 months old. Significant correlations were found between infant sleep and growth after controlling for potential infant and family confounding factors. Actigraphic sleep percentage and reported sleep duration were correlated negatively with the weight-to-length ratio measures. Sex-related differences in the associations between sleep and physical growth were found. Breast feeding at night was correlated with a more fragmented sleep, but not with physical growth. These findings suggest that sleep is related significantly to physical growth as early as in the first months of life. The study supports increasing evidence from recent studies demonstrating a link between short sleep duration and weight gain and obesity in young children.

Cross-cultural differences in infant and toddler sleep

Background To characterize cross-cultural sleep patterns and sleep problems in a large sample of children ages birth to 36 months in multiple predominantly-Asian (P-A) and predominantly-Caucasian (P-C) countries. Methods Parents of 29,287 infants and toddlers ( predominantly-Asian countries/regions: China, Hong Kong, India, Indonesia, Korea, Japan, Malaysia, Philippines, Singapore, Taiwan, Thailand, Vietnam; predominantly-Caucasian countries: Australia, Canada, New Zealand, United Kingdom, United States) completed an internet-based expanded version of the Brief Infant Sleep Questionnaire. Results Overall, children from P-A countries had significantly later bedtimes, shorter total sleep times, increased parental perception of sleep problems, and were more likely to both bed-share and room-share than children from P-C countries, p < .001. Bedtimes ranged from 19:27 (New Zealand) to 22:17 (Hong Kong) and total sleep time from 11.6 (Japan) to 13.3 (New Zealand) hours, p < .0001. There were limited differences in daytime sleep. Bed-sharing with parents ranged from 5.8% in New Zealand to 83.2% in Vietnam. There was also a wide range in the percentage of parents who perceived that their child had a sleep problem (11% in Thailand to 76% in China). Conclusions Overall, children from predominantly-Asian countries had significantly later bedtimes, shorter total sleep times, increased parental perception of sleep problems, and were more likely to room-share than children from predominantly-Caucasian countries/regions. These results indicate substantial differences in sleep patterns in young children across culturally diverse countries/regions. Further studies are needed to understand the basis for and impact of these interesting differences.

A Nightly Bedtime Routine: Impact on Sleep in Young Children and Maternal Mood

Establishment of a consistent bedtime routine is often recommended to parents of young children, especially those with sleep difficulties. However, no studies have investigated the efficacy of such a routine independent of behavioral intervention. Thus, the purpose of this study was to examine the impact of a consistent bedtime routine on infant and toddler sleep, as well as maternal mood. 405 mothers and their infant or toddler (ages 7-18 months, n=206; ages 18-36 months, n=199) participated in 2 age-specific 3-week studies. Families were randomly assigned to a routine or control group. The first week of the study served as a baseline during which the mothers were instructed to follow their child's usual bedtime routine. In the second and third weeks, mothers in the routine group were instructed to conduct a specific bedtime routine, while the control group continued their child's usual routine. All mothers completed the Brief Infant Sleep Questionnaire (BISQ) on a weekly basis and a daily sleep diary, as well as completed the Profile of Mood States. The bedtime routine resulted in significant reductions in problematic sleep behaviors for infants and toddlers. Significant improvements were seen in latency to sleep onset and in number/duration of night wakings, P < 0.001. Sleep continuity increased and there was a significant decrease in the number of mothers who rated their child's sleep as problematic. Maternal mood state also significantly improved. Control group sleep patterns and maternal mood did not significantly change over the 3-week study period. These results suggest that instituting a consistent nightly bedtime routine, in and of itself, is beneficial in improving multiple aspects of infant and toddler sleep, especially wakefulness after sleep onset and sleep continuity, as well as maternal mood.

Sleep Difficulties in Infants at Risk for Developmental Delays: A Longitudinal Study

We compared the sleep of infants at risk for neuromotor delays to that of infants without such risks, and examined the predictive validity of risk indicators to the development of sleep problems. Conveniently recruited infants (n = 142) were assessed for neuromotor achievements and sleep behaviors at 4-6 months and 10-12 months of age. Assessment tools were the Harris Infant Neuromotor Test and Morrell's Infant Sleep Questionnaire. Based on a cumulative risk index, three groups were defined: higher risk (n = 28), lower risk (n = 42), and no risk (n = 72). At both ages, the sleep scores were similar among the groups. In the no risk and lower risk group, sleep difficulties decreased with age, while for infants in the higher risk group, more difficulties were reported over time. Overall, the neuromotor attainments were not related to sleep fragmentation or settling difficulties. In a diverse sample of infants, with and without risks for developmental delays, overall, sleep patterns were similar. It appears that the neuromotor achievements are not associated with sleep-wake regulation, as measured by caregivers' report.

The Role of Maternal Cognitions in Infant Sleep Problems as Assessed by a New Instrument, the Maternal Cognitions about Infant Sleep Questionnaire

Sleeping problems in young children are very common, affecting up to 20% of 1-year-olds. Behaviour therapy is the most widely recognised treatment but a significant proportion of parents find it aversive. This suggests that parental cognitions may be important and underevaluated. The aims of this study were therefore fourfold: (1) to describe the development of a new tool to measure maternal cognitions in relation to infant sleeping problems, the Maternal Cognitions about Infant Sleep Questionnaire (MCISQ): (2) to assess the psychometric properties of the MCISQ; (3) to test the hypothesis that maternal cognitions will be associated with, and specific to, infant sleep problems; and (4) to discuss the implications of the findings with respect to aetiological models of infant sleep problems, treatment, and future research. Results showed that maternal cognitions about setting limits, anger at the infant's demands, and doubts about parenting competence were significantly associated with infant sleep problems, whereas cognitions about infant hunger or cot death were not. It is hypothesised that these cognitive responses, if extreme, may disrupt sensitive parent-child interactions, which over time could lead to impairments in the development of infant self-regulation.

The Role of Maternal Cognitions in Infant Sleep Problems as Assessed by a New Instrument, the Maternal Cognitions about Infant Sleep Questionnaire

The Role of Maternal Cognitions in Infant Sleep Problems as Assessed by a New Instrument, the Maternal Cognitions about Infant Sleep Questionnaire

The Infant Sleep Questionnaire: A New Tool to Assess Infant Sleep Problems for Clinical and Research Purposes

Most published questionnaires for infant sleep problems form part of general questionnaires looking at a wider range of infant behaviours. This paper evaluates the Infant Sleep Questionnaire (ISQ), a maternal selfreport questionnaire designed specifically to assess sleeping behaviour in 12–18-month-old infants. The sensitivity and specificity of the ISQ as compared to maternal sleep diary measures is reported. The use of the ISQ for clinical and research purposes is discussed.

The Infant Sleep Questionnaire: A New Tool to Assess Infant Sleep Problems for Clinical and Research Purposes

Most published questionnaires for infant sleep problems form part of general questionnaires looking at a wider range of infant behaviours. This paper evaluates the Infant Sleep Questionnaire (ISQ), a maternal self- report questionnaire designed specifically to assess sleeping behaviour in 12–18-month-old infants. The sensitivity and specificity of the ISQ as compared to maternal sleep diary measures is reported. The use of the ISQ for clinical and research purposes is discussed.

Maternal perception of night awakenings and infant self-soothing behavior during the first year of life

Establishment of a consistent bedtime routine is often recommended to families with young children with sleep difficulties. However, there are limited studies assessing specific bedtime routines in the treatment of infant and toddler sleep disturbances. Thus, the purpose of this study was to examine the impact of a massage-based bedtime routine on infant sleep, maternal sleep, and maternal mood. A total of 123 mothers and their 3- to 18-month-old infant were randomly assigned to a routine (one-week baseline of usual bedtime routine, two-weeks intervention) or control group (three-weeks of their usual bedtime routine). All mothers completed the Brief Infant Sleep Questionnaire (BISQ) on a weekly basis and measures of maternal sleep and mood (eg, Pittsburgh Sleep Quality Index, Epworth Sleepiness Scale, and Edinburgh Postnatal Depression Scale). This bedtime routine resulted in improvements in child and mother night wakings, maternal perceptions of child sleep and mood (ie, sleep problem, bedtime ease, and morning mood), and improvements in maternal sleep quality. No comparative changes were seen in the control group. Notably, other than number of night wakings for both the child and the mother, there were no changes in other sleep patterns including sleep onset latency, duration of night wakings, longest stretch of sleep, or sleep duration. This study supports recommending a massage-based routine in those families, with the codicil that improvements in maternal perceptions and maternal sleep will be noted, with few improvements in sleep itself other than night wakings.

Review of piezoelectric materials used for ultrasonic transducers

Clinical recommendations include putting infants to bed using a consistent bedtime routine at an appropriate hour to promote longer nighttime sleep. Actigraphy was used in this exploratory study to examine how bedtime routines and nighttime sleep onset were associated with nighttime total sleep time (TST) and efficiency from 6 to 24 weeks of age.Infants (n = 24) wore sleep actigraphs for three, one-week periods at 6, 15, and 24 weeks of age. Nighttime TST, sleep efficiency, sleep onset and offset were quantified. Mothers reported on infant bedtime routines using the Brief Infant Sleep Questionnaire at each age. Multilevel models examined between- and within-person associations.As infants aged, sleep onset was earlier, and bedtime routines became shorter (p's < 0.05). Infants fell asleep between 7 and 8:00PM on 24% of the nights. Most mothers (70%) reported that they often fed infants to sleep for the night. For every 1 h earlier in infants' usual sleep onset, nighttime TST was 34.4 min longer that night (p < 0.01). Infants with earlier than usual sleep onset had slightly earlier sleep offset the next morning (8.4 min for every 1 h earlier in onset; p = 0.02). Between-person analyses showed similar patterns. Infants with a more consistent bedtime routine and who were not typically fed to sleep at bedtime had longer nighttime TST at 6 weeks, with a trend or no association at later ages.Infants who fell asleep earlier also slept longer at night. Keeping infants up later in hopes of them sleeping in longer may be counterproductive.

13 - Assessment of the High Risk Fetus

We sought to examine the effect of maternal sleep-disordered breathing (SDB) on infant general movements (GMs) and neurodevelopment.Pregnant women with uncomplicated full-term pregnancies and their offspring were prospectively recruited from a community and hospital low-risk obstetric surveillance. All participants completed a sleep questionnaire on second trimester and underwent ambulatory sleep evaluation (WatchPAT; Itamar Medical, Caesarea, Israel). They were categorized as SDB (apnea hypopnea index >5) and controls. Infant GMs were assessed in the first 48 hours and at 8-11 and 14-16 weeks of age. At 12 months of age the Infant Developmental Inventory and the Brief Infant Sleep Questionnaire were administered.In all, 74 women and their full-term infants were studied. Eighteen (24%) women had SDB. Mean birthweight was 3347.1 ± 423.9 g. Median Apgar score at 5 minutes was 10 (range, 8–10). In adjusted comparisons, no differences were found between infants born to mothers with SDB and controls in GM scores in all 3 evaluations. Low social developmental score was detected at 12 months in 64% of infants born to SDB mothers compared to 25% of infants born to controls (adjusted P = .036; odds ratio, 16.7). Infant snoring was reported by 41.7% of mothers with SDB compared to 7.5% of controls (P = .004).Our preliminary results suggest that maternal SDB during pregnancy has no adverse effect on neonatal and infant neuromotor development but may affect social development at 1 year.