Parental Sleep Research Articles

Maternal nighttime sleep and infant-mother attachment security: The mediating role of maternal parenting quality during bedtime and free play.

The present study examined mothers' emotional availability (EA) during daytime free play and bedtime as a mediator of linkages between maternal nighttime sleep and infant-mother attachment. Participants included 153 mothers (85% White) with infants (53% female). When infants were 1, 3, 6, 9, and 12 months, maternal sleep was assessed using actigraphy and daily sleep diaries for 7 consecutive days. At each time point, mothers' EA was scored from one observation of daytime free play and from one evening observation of infant bedtime by trained observers who were blind to all other participant information. Average scores were created for maternal sleep and EA across the five occasions in the first year. At 12 and 18 months, infant-mother attachment security in the home was scored by blind observers using the Attachment Q-Set, averaged across the two age points, and used in analyses. Mediational analyses revealed that mothers who experienced highly variable sleep and had poor sleep quality were less emotionally available with infants at bedtime during infants' first year of life, which in turn was predictive of lower infant-mother attachment security in the second year, supporting mediation. Linkages between maternal sleep characteristics and daytime EA were less evident. Later maternal sleep timing was also directly predictive of low attachment security, after accounting for maternal EA. Findings emphasize that poor parental sleep places both parenting and infant socioemotional development at risk, and that parental sleep hygiene and sleep habits should be a salient focus of parenting intervention. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Parental sleep when their child is sick: A phased principle-based concept analysis.

Sleep is a common challenge for parents with sick children and can impact parents' health, wellbeing, and caregiving responsibilities. Despite the vast research around parental sleep when their child is sick, the concept is not clearly defined. A phased principle-based concept analysis that includes triangulation of methods and quality criteria assessment was used to explore how the concept is described, used, and measured in the current literature. The aim was to analyse and clarify the conceptual, operational, and theoretical basis of parental sleep when their child is sick to produce an evidence-based definition and to identify knowledge gaps. A systematic literature search including databases CINAHL, Embase, MEDLINE, PsychARTICLES, PsychINFO, Pubmed, Scopus and Web of Science, identified 546 articles. The final dataset comprised 74 articles published between 2005 and 2021 and was assessed using a criteria tool for principle-based concept analysis. Data were managed using NVivo, and thematic analysis was undertaken. A precise definition is not present in the literature. Various tools have been used to measure parents' sleep, as well as exploration via interviews, open-ended questions, and sleep diaries. The terminology used varied. Parental sleep when their child is sick is interrelated with other concepts (e.g., stress). A recommended definition is offered. A conceptual understanding of parental sleep when their child is sick will help to guide translational research and to conduct studies critical to clinical practice and research. Future research includes developing a measurement tool for parental sleep when their child is sick to be used in study design and future interventions.

Impact of intermittently scanned continuous glucose monitoring with alarms on sleep and metabolic outcomes in children and adolescents with type 1 diabetes.

Data about sleep quality and quantity are not available in patients with type 1 diabetes (T1D) using intermittently scanned continuous glucose monitoring (isCGM). We questioned whether the isCGM with alarms could fragment sleep in patients and parents, compared to isCGM without alarms. A prospective, observational study including 47 child-adolescents with T1D who had experience with isCGM without alarms (Freestyle Libre 1-FSL1). They were asked to wear the isCGM with alarms (Freestyle Libre 2-FSL2) for 14days. Patients enrolled and their caregiver (s), during a 14day period with FSL1 and the following 14days with FSL2, completed psychosocial and sleep-related questionnaires. Furthermore they wore an actigraph that was downloaded to a web platform and processed by the validated and certified algorithm "Dormi®." By the switch to the alarmed FSL2 we found about a 5% increase in Time In Range (from 62.5 to 67.8%), a reduction in time spent in hypoglycemia, number of weekly hypoglycemic events, and coefficient of variation. We did not find significant differences in sleep parameters in patients and their parents; therefore, alarms did not worsen the duration and quality of sleep. A significant improvement in the Quality of Life was perceived by parents using FSL2. Introduction of alarms in isCGM systems gives, in the short term, an improvement in metabolic control in terms of time in range and reduction in hypoglycemia, without worsening duration and quality of sleep, measured by actigraphy, in children-adolescent and their parents.

Age, income and sleep duration were associated with outcomes in children participating in weight management.

AimTo explore associations between baseline factors and weight‐related outcomes among participants enrolled in a paediatric obesity trial.MethodsWe included children aged 6–12 years participating in a 2‐year multidisciplinary family programme who attended a postintervention follow‐up 36 months from baseline (n = 62). Outcome measures were change in body mass index standard deviation score (BMI SDS), reduction in BMI SDS ≥0.25 and change in waist circumference (WC). Independent variables included in linear and logistic regression models were age, sex, household income, parents' education, sleep duration, screen time and physical activity.ResultsAltogether, 26 children (42%) attained a reduction of BMI SDS ≥0.25. Higher family income and longer sleep duration were associated with greater change in BMI SDS (−0.05 per 100.000 NOK, p = 0.02, and −0.24 per hour, p = 0.02, respectively). Higher age was associated with greater change in WC (−2.1 cm per year, p = 0.01) but lower odds of attaining a reduction in BMI SDS ≥0.25 (OR per year 0.70, p = 0.04). There was a borderline statistically significant trend towards greater increase in WC with longer daily screen time (p = 0.05).ConclusionAge, family income and sleep duration at baseline were associated with weight‐related outcomes 1‐year postintervention.

Sleep Deprivation Among School-Going Adolescents in an Urban Setting in Kerala (India); Descriptive Study

Objectives: To study the prevalence of sleep deprivation (SLD) and associated risk factors among school-going adolescents of 9th to 12th grades (13-18 years) in an urban setting in Thiruvananthapuram, Kerala, India. Study Design: Descriptive, cross-sectional study. Methodology: The participants were selected through random sampling. Self-administered structured questionnaire focusing on sleep habits, study habits, before bed screen-time, and parental sleep habits was administered to them. Weight and height were measured to calculate Body Mass Index. Results: Out of the 426 students, 29 were excluded and 302 students (76.07%) had SLD. Mean age was 15.79 years (standard deviation: 1.23). Univariate analysis showed adolescents above 15 years (odds ratio [OR] = 2203, 95% confidence interval [CI]: 1.380-3.517), students of 11th and 12th (OR = 2.205, 95% CI: 1.380-3.523), sleeping after 10 PM (OR = 19.617, 95% CI: 10.586-36.355), waking up before 6 AM (OR = 2.586, 95% CI: 1.554-4.304), sleeping after parents (OR = 2.356, 95% CI: 1.415-3.922) had significant risk. On multivariate analysis, students of 11th and 12th (adjusted OR [aOR] = 3.197, 95% CI: 1.107-9.234), going to bed after 10 PM(aOR = 51.49, 95% CI: 20.211-131.180), waking up before 6 AM (aOR = 51.49, 95% CI: 20.211-131.180), and sleeping after parents (aOR = 1.927, 95% CI: 1.011-3.673) were significant. Conclusion: Prevalence of SLD among adolescents aged 13 to 18 years was 76.07%. Higher secondary classes, going to sleep after 10 PM, waking up before 6 AM, and sleeping after parents had significant SLD. Good sleep habits can be promoted by including their importance in school curriculum.

The associations of parental COVID-19 related worries, lifestyles, and insomnia with child insomnia during the COVID-19 outbreak.

The impacts of the Coronavirus Disease 2019 (COVID‐19) pandemic on sleep health have been studied extensively. However, little is known about sleep problems within the family system during the pandemic. This study aimed to examine the influence of the COVID‐19 pandemic on insomnia in both adults and children, and to explore whether parental COVID‐19 related worries, lifestyles, and insomnia were associated with child insomnia. A total of 1355 parent–child dyads (39.2% fathers, mean age 38.37 years, SD = 5.34; 52.7% boys, mean age 12.47 years, SD = 1.67) were recruited from Jiangxi province in China from 4 to 18 February 2020. Data on insomnia, COVID‐19 related worries, physical activity, and screen time were collected using online questionnaires. Path analysis showed that COVID‐19 related worries and screen time were positively associated with insomnia in both parents and children; while children's physical activity was negatively related to children's insomnia. Parents' insomnia, COVID‐19 related worries, physical activity, and screen time were positively associated with children's insomnia, COVID‐19 related worries, physical activity, and screen time, respectively. Bootstrap tests showed that parents' worries were positively associated with children's insomnia via parents' insomnia and children's worries; parents' physical activity was negatively associated with children's insomnia via children's physical activity, parents' screen time was positively associated with children's insomnia via parents' insomnia and children's screen time. Both parental and child sleep are affected by the pandemic. Parental insomnia, stress reaction, and lifestyles contribute to child insomnia. Child sleep health may be maintained or improved by family bonds, home exercise, and sleep schedules.

Multi-level predictors of depression symptoms in the Adolescent Brain Cognitive Development (ABCD) study.

While identifying risk factors for adolescent depression is critical for early prevention and intervention, most studies have sought to understand the role of isolated factors rather than across a broad set of factors. Here, we sought to examine multi-level factors that maximize the prediction of depression symptoms in US children participating in the Adolescent Brain and Cognitive Development (ABCD) study. A total of 7,995 participants from ABCD (version 3.0 release) provided complete data at baseline and 1-year follow-up data. Depression symptoms were measured with the Child Behavior Checklist. Predictive features included child demographic, environmental, and structural and resting-state fMRI variables, parental depression history and demographic characteristics. We used linear (elastic net regression, EN) and non-linear (gradient-boosted trees, GBT) predictive models to identify which set of features maximized prediction of depression symptoms at baseline and, separately, at 1-year follow-up. Both linear and non-linear models achieved comparable results for predicting baseline (EN: MAE = 3.757; R2 = 0.156; GBT: MAE = 3.761; R2 = 0.147) and 1-year follow-up (EN: MAE = 4.255; R2 = 0.103; GBT: MAE = 4.262; R2 = 0.089) depression. Parental history of depression, greater family conflict, and shorter child sleep duration were among the top predictors of concurrent and future child depression symptoms across both models. Although resting-state fMRI features were relatively weaker predictors, functional connectivity of the caudate was consistently the strongest neural feature associated with depression symptoms at both timepoints. Consistent with prior research, parental mental health, family environment, and child sleep quality are important risk factors for youth depression. Functional connectivity of the caudate is a relatively weaker predictor of depression symptoms but may represent a biomarker for depression risk.

Application of a Risk Management Framework to Parent Sleep During Skin-to-Skin Care in the NICU

As NICU staff work to increase the frequency, duration, and comfort of skin-to-skin care (SSC) sessions, barriers to implementation are frequently encountered. Safety concerns are often raised when parents fall asleep during SSC intentionally or unintentionally. We present a risk management framework that we use in clinical practice to address risk related to parent sleep during SSC. Our approach is based on the steps of the Risk Management Life Cycle, which include the following: establish context, identify risk, analyze risk, respond to risk, and monitor and adapt response to risk. Clinicians may use this framework in clinical practice to manage risks related to prolonged SSC, specifically when parents relax and fall asleep during SSC.

A quasi-experimental study of parent and child well-being in families of color in the context of COVID-19 related school closure

Families of color living in historically disinvested neighborhoods face a multitude of health disparities which have been exacerbated by COVID-19 and the resulting strategies to mitigate its transmission. School closure, which occurred with little warning and few, if any, resources for preparation, disrupted multiple aspects of families’ lives; these disruptions are anticipated to adversely impact mental health and well-being. The current study aims to advance understanding of the experiences of families of young children of color during the pandemic by utilizing a natural experiment design to test impact on child and parent mental health and sleep in the context of COVID-19 related school closure among families in historically disinvested neighborhoods. Data from this study come from an ongoing study of 281 families of color enrolled in 41 pre-kindergarten (pre-K) programs in neighborhoods across New York City (NYC). In NYC, school closure occurred on March 16, 2020, during a data collection period involving phone surveys with parents; the quasi-experimental design allows for comparison of the 198 families who had completed the survey prior to March 16, and the 83 families who completed the survey after March 16, using identical protocols and procedures. Results demonstrate poorer mental health among parents surveyed after school closure as compared to before school closure. No differences were found for parent sleep, child mental health, or child sleep. Implications of this work highlight the need for structural and systemic supports for families faced with compounding stressors as a result of the COVID-19 pandemic and related school closure.

Improvements in Parental Sleep, Fear of Hypoglycemia, and Diabetes Distress With Use of an Advanced Hybrid Closed-Loop System.

Parental sleep quality may contribute to glycemic control in youth with type 1 diabetes. In this article we present sleep analysis from a multicenter, randomized trial of children ages 6-13 years with type 1 diabetes evaluating the Tandem Control-IQ (CIQ) hybrid closed-loop (HCL) system. Pittsburgh Sleep Quality Index (PSQI) scores were assessed at baseline to identify parents as "poor" sleepers (PSQI >5). Glycemic and psycho-behavioral outcomes before and after CIQ use were analyzed in poor sleepers (n = 49) and their children. Nocturnal time in range (P < 0.001) and time hyperglycemic (P < 0.001), Hypoglycemia Fear Survey for Parents score (P < 0.001), Problem Areas in Diabetes scale score (P < 0.001), PSQI score (P < 0.001), and Hypoglycemia Fear Survey for Children score (P = 0.025) significantly improved. Of poor sleepers, 27 became good sleepers (PSQI score <5). Use of CIQ in youth with type 1 diabetes ages 6-13 years significantly improved sleep and psychosocial measures in parent poor sleepers, coinciding with improvements in child nocturnal glycemia, highlighting the relationship between HCL systems and parent sleep quality.

Child and Parent Physical Activity, Sleep, and Screen Time During COVID-19 and Associations With Mental Health: Implications for Future Psycho-Cardiological Disease?

The COVID-19 pandemic has afforded the opportunity for some to improve lifestyle behaviours, while for others it has presented key challenges. Adverse changes in global lifestyle behaviours, including physical activity, sleep, and screen time can affect proximal mental health and in turn distal cardiovascular outcomes. We investigated differences in physical activity, sleep, and screen time in parents and children during early stages of the COVID-19 pandemic in Australia compared to pre-COVID-19 national data; and estimated associations between these movement behaviours with parent and child mental health. Cross-sectional baseline data from the COVID-19 Pandemic Adjustment Study (CPAS; N = 2,365) were compared to nationally representative pre-pandemic data from the Longitudinal Study of Australian Children (LSAC; N = 9,438). Participants were parents of children aged ≤ 18 years, residing in Australia. Parents provided self-report measures of mental health, physical activity and sleep quality, and reported on child mental health, physical activity and screen time. Children in CPAS had significantly more sleep problems and more weekend screen time. Their parents had significantly poorer sleep quality, despite increased weekly physical activity. Children's sleep problems were significantly associated with increased mental health problems, after accounting for socioeconomic status, physical activity, and screen time. Poorer parent sleep quality and lower levels of physical activity were significantly associated with poorer mental health. Monitoring this cohort over time will be important to examine whether changes in movement behaviour are enduring or naturally improve with the easing of restrictions; and whether these changes have lasting effects on either parent or child mental health, and in turn, future risk for CVD.

Meeting families where they sleep: a collaborative approach to improving sleep health for urban children.

Meeting families where they sleep: a collaborative approach to improving sleep health for urban children.

Distance Interventions for Children with Sleep Problems: A Review

Sleep problems in childhood are frequent and may cause damage to the children and their families; however, parental orientation appears to be effective in its many new formats, such as the distance treatment. This study aimed to review the literature about behavioral intervention performed by distance to sleep problems in childhood and summarize the main characteristics of such interventions. Searches were performed up to November 2021 in BVS Psicologia ULAPSI Brasil, SCOPUS, and PsycINFO, using the key words: sleep problems, insomnia, nighttime fears, behavioral intervention, behavioral treatment, treatment, intervention, sleep, behavior, child, children, infant, mobile phones, smartphone, app, telephone, online, internet, bibliotherapy. We included 14 studies. The main results indicate that interventions were implemented between 2 and 12 weeks, the most reported procedure was pre-sleep routines, and semipresential interventions that required some presential contact were the most frequent. Written educational information about sleep through bibliotherapy and telephone contacts were the most used tools to implement the remote component of interventions. Ten studies indicated improvements on children’s sleep, and secondary results (parental sleep and/or mental health) were also reported among studies. Therefore, our findings suggest that distance interventions for childhood sleep problems are promising, but future research is still needed

Child Sleep Problems Affect Mothers and Fathers Differently: How Infant and Young Child Sleep Affects Paternal and Maternal Sleep Quality, Emotion Regulation, and Sleep-Related Cognitions.

PurposeProblems in infant and young child sleep can represent a serious challenge to parental behavior of mother and father. However, most research about the effect of infant and young child sleep on parenting has focused on mothers. Therefore, the present study aimed to explore the perception and consequences of infant and young child sleep problems of both parents.Participants and MethodsParticipants were recruited via random sampling at, eg, kindergartens in North Rhine Westphalia. The sample includes data of heterosexual German-speaking couples with children without any medical or psychopathological problems. For this study, parents were asked to complete the test battery with regard to their youngest child. As sampling was via the kindergarten, the range of child age was 4–68 months. A survey assessed data of parents (N=196, 46% female). The test battery contained the following questionnaires: Children Sleep Habits Questionnaire (CSHQ), Pittsburgh Sleep Quality Index (PSQI), Self-Report Measure for the Assessment of Emotion Regulation Skills (SEK-27), and a German version of the Infant Sleep Vignettes Interpretation Scale (ISVIS). For the outcome variables of parental sleep as well as for parental emotional competence, the statistical tests of ANOVA were used, and for parental sleep-related cognitions with the grouping variables of infant and young child sleep as well as parental gender, a MANOVA was used. According to the analysis of group differences, the age of the child was also included additional to the grouping variable of parental gender and children’s sleep.ResultsMothers and fathers in this sample were equally aware of their children’s sleep problems and reported similar sleep quality and emotion regulation themselves (all p > 0.05). Mothers as well as fathers of children with sleep problems had lower parental sleep quality (F(1, 183) = 110.01, p < 0.001) and emotion regulation (F(1, 184) = 143.16, p < 0.001) compared to parents of children without sleep problems. In children under 26 months of age, the child’s age seemed to have less negative impact on the father’s sleep quality (F(1, 183) = 5.01, p < 0.001) and emotion regulation (F(1, 184) = 0.72, p < 0.05) than on the outcomes of the mother. With regard to sleep-related cognition, there were statistically significant effects of parental gender (F(2, 185) = 44.39, p < 0.001) and interaction effects of parental gender × child sleep problems observed (F(2, 185) = 31.91, p < 0.001).ConclusionThe conclusion from this survey refers to the role of the father. According to the results, an association between paternal emotional competence, sleep quality as well as their sleep-related cognitions and infants and toddlers sleep behavior could be assumed in addition to and independent of the results of mothers. We would highlight the urgent need of inclusion of fathers in infant and developmental sleep research. In the context of sleep intervention, both parents should be provided with ongoing support to improve their sleep quality and competence in emotion regulation.

Familial Risk of Attention-Deficit/Hyperactivity Disorder and Parental Obstructive Sleep Apnea: A Nationwide Nested Case–Control Study

Familial Risk of Attention-Deficit/Hyperactivity Disorder and Parental Obstructive Sleep Apnea: A Nationwide Nested Case–Control Study

Relationship between the Chronotype of Preschoolers and Parental Sleep Habits

Relationship between the Chronotype of Preschoolers and Parental Sleep Habits

Lost in translation—the influence of language on infant sleep research

ObjectivesWe consider whether language shapes cultural interpretations of sleep in the family context using ethnographic data from the Czech Republic to explore one of the methods employed by Czech parents in helping their children aged 0-3 years to fall asleep. MethodsMulti-methodological ethnographic data were collected in the Czech Republic during 2015-2018 with supplemental online data obtained in 2020. This involved focus groups with 90 participants in mother-baby centers, and interviews with 30 families, supplemented with 468 online responses. ResultsIn the Czech Republic the use of parental presence with or without physical contact to help a child to fall asleep is a widespread practice. It is well-embedded within Czech culture and referred to by a widely known term: Uspávání. Parents expressed multiple motivations for using Uspávání to help their child sleep. DiscussionWithin much of the Anglophone sleep literature the practice of actively helping a child to fall asleep is perceived as problematic. A child who cannot fall asleep alone is considered to exhibit “behavioral insomnia of childhood,” and parents are advised to prevent this “sleep problem” by promoting self-soothing techniques in infancy. We suggest that as there is no English-language equivalent for the word Uspávání the concept it encapsulates is under-valued by sleep researchers, and the practice and its consequences are insufficiently researched. ConclusionsSome important variations in parental sleep practices that are embedded in everyday family systems lack English terminology; Uspávání is one such example. This may lead to researchers overlooking or rejecting the validity of such diverse family sleep practices. There is a need for more ethnographic research of sleep in the context of different cultural environments and family systems to explore how language constrains understanding of parent-child sleep.

Comparing contributors of parental sleep health in families with and without a child with Duchenne muscular dystrophy

BackgroundThe sleep health of caregivers of children with Duchenne muscular dystrophy (DMD) is often overlooked in clinical practice and research. This study characterizes the sleep health of caregivers of children with DMD (4-17 years) compared to parents of age-matched, unaffected children. We explore potential contributors to parental sleep efficiency and hypothesize that child awakenings will have a considerable influence on parental sleep efficiency. MethodsIn this observational study, parents and their children were asked to wear the ActiGraph GT9X Link at night for 1 month. From these data, actigraphy variables (eg, percent sleep efficiency, nocturnal awakenings) were calculated and averaged for parents and children. We also used the Pittsburgh Sleep Quality Index (PSQI) to measure subjective sleep quality. Main findingsParents in the DMD group (n = 25, M = 84.5%) had significantly worse sleep efficiency compared to controls (n = 15, M = 87.8%, p = .048). This difference was sustained after controlling for parent age, child age, and average child awakenings (F(4, 23) = 2.68, p= .057, R2 = .32). Additionally, more parents in the DMD group scored as “poor sleepers” on the PSQI (above 5, 50%) compared to controls (23%), suggesting a strong, yet not statistically significant association between subjective poor sleep and group (χ2(1) = 2.47, p = .116, OR = 3.33). ConclusionParents of children with DMD exhibit both objective and subjective differences suggesting their sleep is impaired. Interestingly, these sleep concerns are not significantly explained by child awakenings as hypothesized. Future research is needed to fully understand the prevalence and cause of poor sleep in a larger group of DMD caregivers as well as direct care for caregivers of children with disabilities.

Do Mothers Have Worse Sleep Than Fathers? Sleep Imbalance, Parental Stress, and Relationship Satisfaction in Working Parents.

PurposePrevious research indicates that mothers take a larger responsibility for child care during the night and that they have more disturbed sleep than fathers. The purpose of this study was to determine whether such a sleep imbalance exists in working parents of young children, and the extent to which it depends on the way sleep is measured. The study also examined whether imbalanced sleep between parents predicts parental stress and relationship satisfaction.MethodsSleep was measured for seven consecutive days in 60 parenting couples (average age of the youngest child: 3.3 years ± SD 2.5 years). Actigraphs were worn across the week, and ratings of sleep, parental stress, and relationship satisfaction were made daily.ResultsMothers perceived their sleep quality as worse (b= −0.38 scale units, p<0.001), with more wake periods (b= +0.96 awakenings, p<0.001) but with longer sleep duration (b= +32.4 min, p<0.01) than fathers. Actigraphy data confirmed that mothers slept longer than fathers (b= +28.03 min, p<0.001), but no significant differences were found for wake time, number of awakenings or who woke up first during shared awakenings. Furthermore, there was no difference in whether mothers and fathers slept sufficiently. The level of sleep imbalance between parents did not predict parental stress. A larger imbalance in subjective sleep sufficiency predicted decreased relationship satisfaction for fathers (b= −0.13 scale units, p<0.01) but increased relationship satisfaction for mothers (b= 0.14 scale units, p<0.05). No other sleep imbalance measures predicted relationship satisfaction.ConclusionOur findings are in line with previous research on sleep in men and women in general, with longer sleep and subjective reports of sleep disturbances in women, rather than previous research on sleep in parents of young children. Thus, we found no evidence of a sleep imbalance when both parents have similar working responsibilities.

A Chatbot to Engage Parents of Preterm and Term Infants on Parental Stress, Parental Sleep, and Infant Feeding: Usability and Feasibility Study.

BackgroundParents commonly experience anxiety, worry, and psychological distress in caring for newborn infants, particularly those born preterm. Web-based therapist services may offer greater accessibility and timely psychological support for parents but are nevertheless labor intensive due to their interactive nature. Chatbots that simulate humanlike conversations show promise for such interactive applications.ObjectiveThe aim of this study is to explore the usability and feasibility of chatbot technology for gathering real-life conversation data on stress, sleep, and infant feeding from parents with newborn infants and to investigate differences between the experiences of parents with preterm and term infants.MethodsParents aged ≥21 years with infants aged ≤6 months were enrolled from November 2018 to March 2019. Three chatbot scripts (stress, sleep, feeding) were developed to capture conversations with parents via their mobile devices. Parents completed a chatbot usability questionnaire upon study completion. Responses to closed-ended questions and manually coded open-ended responses were summarized descriptively. Open-ended responses were analyzed using the latent Dirichlet allocation method to uncover semantic topics.ResultsOf 45 enrolled participants (20 preterm, 25 term), 26 completed the study. Parents rated the chatbot as “easy” to use (mean 4.08, SD 0.74; 1=very difficult, 5=very easy) and were “satisfied” (mean 3.81, SD 0.90; 1=very dissatisfied, 5 very satisfied). Of 45 enrolled parents, those with preterm infants reported emotional stress more frequently than did parents of term infants (33 vs 24 occasions). Parents generally reported satisfactory sleep quality. The preterm group reported feeding problems more frequently than did the term group (8 vs 2 occasions). In stress domain conversations, topics linked to “discomfort” and “tiredness” were more prevalent in preterm group conversations, whereas the topic of “positive feelings” occurred more frequently in the term group conversations. Interestingly, feeding-related topics dominated the content of sleep domain conversations, suggesting that frequent or irregular feeding may affect parents’ ability to get adequate sleep or rest.ConclusionsThe chatbot was successfully used to collect real-time conversation data on stress, sleep, and infant feeding from a group of 45 parents. In their chatbot conversations, term group parents frequently expressed positive emotions, whereas preterm group parents frequently expressed physical discomfort and tiredness, as well as emotional stress. Overall, parents who completed the study gave positive feedback on their user experience with the chatbot as a tool to express their thoughts and concerns.Trial RegistrationClinicalTrials.gov NCT03630679; https://clinicaltrials.gov/ct2/show/NCT03630679