Sleep Location Research Articles

Mothers Falling Asleep During Infant Feeding.

Falling asleep while feeding (FAF) infants is common. Our primary objectives were to examine (1) maternally reported prevalence of FAF and if planned; (2) association between FAF and sociodemographic factors, feeding method, and sleep location; and (3) if receipt of education about safe sleep and bedsharing risks was associated with FAF. In the Social Media and Risk-reduction Training study, US mothers of newborns were randomized to educational messaging promoting infant safe sleep or breastfeeding. We analyzed data from 1259 mothers who responded to the postpartum survey (mean infant age, 11.2 weeks). We used generalized estimating equation logistic regression models to examine the extent that sociodemographic characteristics, feeding type, usual nighttime feeding location, and intervention group were associated with FAF. A total of 28.2% of mothers reported FAF usually or sometimes in the last 2 weeks, 83.4% of whom reported that FAF was unplanned. There were no differences in the odds of FAF by sociodemographic factors. Compared with mothers whose nighttime feeding location was their bed, mothers who reported feeding in a chair were less likely to FAF (33.6% versus 16.8%; adjusted odds ratio, 0.41; 95% confidence interval, 0.31-0.56). FAF was reported less frequently by mothers who received safe sleep interventions (15.6%), compared with mothers who received breastfeeding interventions (33.0%; adjusted odds ratio, 0.40; 95% confidence interval, 0.25-0.65). FAF is reported commonly among US mothers and is predominantly unplanned. Mothers who received safe sleep messaging were less likely to report FAF. New parents need guidance on planning for optimal safety during infant feeding.

Understanding street-exposure and abuse among street-involved children and youth in Kenya: structural intervention insights from routinely collected program data.

Street-involved children and youth (SICY) face significant challenges, including structural and social exclusion, and multiple forms of abuse. Global estimates indicate there are 10-15 million SICY worldwide, with over 250 000 in Kenya alone. There is limited understanding of the timing of these abuse experiences, which may inform interventional efforts. This study analysed relationships between the duration of street exposure, sleep location and experiences of abuse among formerly SICY (aged 6-19 years) in Kenya. Data were collected from participants in the Watoto wa Ahadi Rescue Center programme over a 6-year period (2016-2022). Abuse experiences were categorised into physical, emotional, economic and sexual abuse. Statistical analyses, including Lowess-curve plots and piecewise logit regression, were used to explore the relationships between street exposure duration, sleep location and reported abuse experiences. The sample consisted of 228 unique children, predominantly male, with a mean age of 13.2 years. Physical abuse (37%), emotional abuse (36%), economic abuse (28%) and any abuse (69%) were common, while sexual abuse (5.7%) was less frequently reported. The probability of experiencing abuse varied with the duration of street exposure, with significant increases observed for those on the street for 3 weeks or more. Sleeping under verandas was associated with higher odds of economic abuse and any type of abuse. Longer street exposure did not further increase the odds of physical, economic or any abuse beyond 10 months. Children and youth living on the streets experience high levels of abuse, underscoring the need for data-informed, trauma-informed approaches to support their reintegration. The findings highlight the importance of early intervention and tailored strategies that address the specific timing and types of abuse experienced by SICY. Policy and funding should focus on preventing street migration, providing alternative living locations and supporting long-term reintegration efforts to protect and empower SICY.

Disparities in Spatial Access to Sleep Health Care in the United States: A Population-Based Geospatial Analysis

ObjectivesTo examine spatial access to sleep health care in the United States and investigate associations with demographic and socioeconomic characteristics, thereby identifying high-risk communities with limited spatial access to sleep health service. DesignA cross-sectional population-based geospatial analysis. Settings and ParticipantsResidents in US Census tracts across the 48 contiguous states, Alaska, and Hawaii. MethodsThe 2020 American Community Survey 5-year estimates, 2010 rural-urban commuting area codes, 2020 Area Deprivation Index, and sleep care provider locations from the National Provider Identifier file were used to assess the spatial access and related demographic/socioeconomic characteristics. Spatial access was measured by spatial access ratio using enhanced 2-step floating catchment area methods. The associations were investigated using logistic regression analysis and multivariate linear regression analysis. ResultsA total of 45.8 million residents experienced low spatial access to sleep health care. Spatial access decreased in rural and high Area Deprivation Index areas, and in areas characterized by higher population with uninsured status, vehicle unavailability, internet unavailability, cognitive difficulties, and hearing difficulties. With a 10% increase in the percentage of the racial minority (non-white) population, metropolitan census tracts experienced an increase in spatial access (3.268%), whereas micropolitan (−1.526%) and rural (−4.493%) areas experienced a decrease in spatial access. Similar findings were observed within the ethnic minority (Hispanic or Latino) population. Conclusions and ImplicationsDisparities exist in spatial access to sleep health care across the United States, especially for disadvantaged individuals. Racial/ethnic minorities exhibit contrasting spatial access patterns in urban and rural areas, with those in rural areas facing more challenges in spatial access to sleep health care.

Community partnership approaches to safe sleep (CPASS) program evaluation

BackgroundSudden unexpected infant death (SUID) continues to be a leading cause of death in infants in the United States (US), with significant disparities by race and socio-economic status. Infant safe sleep behaviors are associated with decreasing SUID risk, but challenges remain for families to practice these routinely. The objective of this program was to implement and evaluate a novel approach for an infant safe sleep pilot program built upon partnerships between hospitals and community-based organizations (CBOs) serving pregnant and parenting families in at-risk communities.MethodsCommunity Partnership Approaches to Safe Sleep (CPASS) was a prospectively implemented infant safe sleep program. CPASS included children’s hospitals partnered with CBOs across five US cities: Portland, OR, Little Rock AR, Chicago, IL, Birmingham, AL, and Rochester, NY. The program consisted of (1) monthly learning community calls; (2) distribution of Safe Sleep Survival Kits; and (3) surveys of sites and families regarding program outcomes. Survey measures included (1) site participation in CPASS activities; (2) recipients’ use of Safe Sleep Kits; and (3) recipients’ safe sleep knowledge and behaviors.ResultsCPASS learning community activities were consistently attended by at least two representatives (1 hospital-based, 1 CBO-based) from each site. Across the five sites, 1002 safe kits were distributed over 9 months, the majority (> 85%) to families with infants ≤ 1 month old. Among participating families, 45% reported no safe sleep location before receipt of the kit. Family adherence to nighttime safe sleep recommendations included: (1) no bedsharing (M 6.0, SD 1.8, range 0–7); (2) sleep on back (M 6.3, SD 1.7, range 0–7); and (3) sleep in a crib with no blankets/toys (M 6.0, SD 2.0, range 0–7). Site interviews described how participation in CPASS influenced safe sleep conversations and incorporated local data into counseling. Hospital-CBO relationships were strengthened with program participation.ConclusionsThe CPASS pilot program provides a new, innovative model built on hospital-community partnerships for infant safe sleep promotion in SUID-impacted communities. CPASS reached families before their infant’s peak age risk for SUID and empowered families with knowledge and resources to practice infant safe sleep. Important lessons learned included improved ways to center and communicate with families.

Spatial roost networks and resource selection of female wild turkeys.

Wildlife demography is influenced by behavioural decisions, with sleep being a crucial avian behaviour. Avian species use roost sites to minimize thermoregulation costs, predation risk and enhance foraging efficiency. Sleep locations are often reused, forming networks within the home range. Our study, focusing on female eastern wild turkeys (Meleagris gallopavo silvestris) during the reproductive season, used social network analysis to quantify both roost site selection and network structure. We identified roost networks which were composed of a small percentage of hub roost sites connecting satellite roosts. Hub roosts were characterized by greater values of betweenness (β = 0.62, s.e. = 0.02), closeness (β = 0.59, s.e. = 0.03) and eigenvalue centrality (β = 1.15, s.e. = 0.05), indicating their importance as connectors and proximity to the network's functional centre. The probability of a roost being a hub increased significantly with greater eigenvalue centrality. Female wild turkeys consistently chose roost sites at lower elevations and with greater topographical ruggedness. Hub roost probability was higher near secondary roads and further from water. Our research highlights well-organized roost site networks around hub roosts, emphasizing the importance of further investigations into how these networks influence conspecific interactions, reproduction and resource utilization in wild turkeys.

Understanding patterns of fatigue in health and disease: protocol for an ecological momentary assessment study using digital technologies

IntroductionFatigue is prevalent across a wide range of medical conditions and can be debilitating and distressing. It is likely that fatigue is experienced differently according to the underlying aetiology, but...

A new approach to geostatistical synthesis of historical records reveals capuchin spatial responses to climate and demographic change.

Recent proliferation of GPS technology has transformed animal movement research. Yet, time-series data from this recent technology rarely span beyond a decade, constraining longitudinal research. Long-term field sites hold valuable historic animal location records, including hand-drawn maps and semantic descriptions. Here, we introduce a generalised workflow for converting such records into reliable location data to estimate home ranges, using 30 years of sleep-site data from 11 white-faced capuchin (Cebus imitator) groups in Costa Rica. Our findings illustrate that historic sleep locations can reliably recover home range size and geometry. We showcase the opportunity our approach presents to resolve open questions that can only be addressed with very long-term data, examining how home ranges are affected by climate cycles and demographic change. We urge researchers to translate historical records into usable movement data before this knowledge is lost; it is essential to understanding how animals are responding to our changing world.

Maternal depressive symptoms and mother-infant cosleeping (including room sharing and bedsharing): a systematic review.

Maternal depressive symptoms (MDS) affect most women during the first year postpartum. Mothers provide most of the nighttime care for infants, so studying the relationship between MDS and infant sleep location (ISL) is highly relevant to understanding maternal mental health over the first year of life and beyond. Infant sleep is studied by anthropologists, health care providers, and psychologists, with very little communication across disciplines. This review aimed to determine whether there is a predictive relationship between MDS and ISL. This systematic review searched 6 databases with terms related to maternal mood and ISL. Final analysis included 14 published studies, analyzed with narrative synthesis and Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Included studies directly compared ISL and MDS. Five studies showed no relationship between ISL and MDS, and 1 study found bedsharing reduced MDS. Five studies found cosleeping was related to higher MDS although directionality is mixed or missing, and 3 studies found an association at some ages or for some populations only. Examining studies according to type of infant sleep assessment, study design, age of infant, or breastfeeding status failed to detect consistent patterns. A variety of study designs, types and definitions of variable measures, sample recruitment, and study outcomes prevent detection of a consistent relationship between MDS and ISL. We explore reasons for the elusive nature of a relationship and make recommendations for future research in MDS and ISL, including crossdisciplinary collaborations. Barry ES, D'Souza L. Maternal depressive symptoms and mother-infant cosleeping (including room sharing and bedsharing): a systematic review. J Clin Sleep Med. 2024;20(9):1517-1533.

The Tension Between AAP Safe Sleep Guidelines and Infant Sleep.

To understand tension mothers experience when attempting to follow American Academy of Pediatrics safe sleep guidelines and enhancing infant and parental sleep. Surveys and focus groups were conducted from November 2022 and March 2023 with United States-based English-speaking mothers of infants <6 months of age recruited via social media and who reported a nonrecommended sleep position and/or location ≥2 times the prior week. Twenty-five mothers participated in focus groups and surveys. A total of 80% reported holding or rocking their infant to sleep; 76% fed their infant to sleep. Almost all were aware of the ABCs (Alone, Back, Crib) of safe sleep and intended to follow them before delivery. Many felt that ABCs were unrealistic and placed their infants in nonrecommended locations or positions because they perceived them as more comfortable and helping their infant fall and stay asleep. Mothers were more likely to use nonrecommended practices when they were awake or sleeping nearby and believed they could closely monitor their infant. Some questioned whether ABCs were the only way to achieve safe sleep. Some prioritized other safety concerns (eg, fall prevention) over sudden infant death syndrome or sudden unexpected infant death prevention. Mothers expressed confidence about getting their baby to sleep in general but were less confident that they could do this while following guidelines. Despite awareness of the ABCs, mothers regularly engaged in nonrecommended practices with the goal of improving their own and their infant's sleep. Interventions focused on improving infant and parental sleep while maintaining sleep safety are needed.

Characteristics of Sudden Unexpected Infant Deaths on Shared and Nonshared Sleep Surfaces.

Describe characteristics of sudden unexpected infant deaths (SUID) occurring on shared or nonshared sleep surfaces. We examined SUID among residents of 23 US jurisdictions who died during 2011 to 2020. We calculated frequencies and percentages of demographic, sleep environment, and other characteristics by sleep surface sharing status and reported differences of at least 5% between surface sharing and nonsharing infants. Of 7595 SUID cases, 59.5% were sleep surface sharing when they died. Compared with nonsharing infants, sharing infants were more often aged 0 to 3 months, non-Hispanic Black, publicly insured, found supine, found in an adult bed or chair/couch, had a higher number of unsafe sleep factors present, were exposed to maternal cigarette smoking prenatally, were supervised by a parent at the time of death, or had a supervisor who was impaired by drugs or alcohol at the time of death. At least 76% of all SUID had multiple unsafe sleep factors present. Among surface-sharing SUID, most were sharing with adults only (68.2%), in an adult bed (75.9%), and with 1 other person (51.6%). Surface sharing was more common among multiples than singletons. Among SUID, surface sharing and nonsharing infants varied by age at death, race and ethnicity, insurance type, presence of unsafe sleep factors, prenatal smoke exposure, and supervisor impairment. Most SUID, regardless of sleep location, had multiple unsafe sleep factors present, demonstrating the need for comprehensive safe sleep counseling for every family at every encounter.

Neurophysiological and behavioral synchronization in group-living and sleeping mice

Social interactions profoundly influence animal development, physiology, and behavior. Yet, how sleep-a central behavioral and neurophysiological process-is modulated by social interactions is poorly understood. Here, we characterized sleep behavior and neurophysiology in freely moving and co-living mice under different social conditions. We utilized wireless neurophysiological devices to simultaneously record multiple individuals within a group for 24 h, alongside video acquisition. We first demonstrated that mice seek physical contact before sleep initiation and sleep while in close proximity to each other (hereafter, "huddling"). To determine whether huddling during sleep is a motivated behavior, we devised a novel behavioral apparatus allowing mice to choose whether to sleep in close proximity to a conspecific or in solitude, under different environmental conditions. We also applied a deep-learning-based approach to classify huddling behavior. We demonstrate that mice are willing to forgo their preferred sleep location, even under thermoneutral conditions, to gain access to social contact during sleep. This strongly suggests that the motivation for prolonged physical contact-which we term somatolonging-drives huddling behavior. We then characterized sleep architecture under different social conditions and uncovered a social-dependent modulation of sleep. We also revealed coordination in multiple neurophysiological features among co-sleeping individuals, including in the timing of falling asleep and waking up and non-rapid eye movement sleep (NREMS) intensity. Notably, the timing of rapid eye movement sleep (REMS) was synchronized among co-sleeping male siblings but not co-sleeping female or unfamiliar mice. Our findings provide novel insights into the motivation for physical contact and the extent of social-dependent plasticity in sleep.

The impact of COVID-19 pandemic on pet behavior and human-animal interaction: a longitudinal survey-based study in the United States

IntroductionAlthough multiple studies have explored behavioral changes in pets during the strict lockdown of the COVID-19 pandemic between May and July 2020, this longitudinal study uniquely investigated the phases beyond strict lockdown. The primary objective of this research was to evaluate the pandemic’s impact on pet behavior.MethodsTo achieve this goal, we conducted an online survey, completed by pet owners residing in the United States between June 2020 (including retrospective data for February and April 2020) and December 2021. The study encompassed four distinct pandemic phases: Pre-pandemic (data collected retrospectively), Strict lockdown, Prolonged lockdown, and Re-opening.Results and discussionThe data collected from surveys completed by 3,278 pet owners across one to six time points revealed declining trends in all investigated behavior problems of both dogs and cats. Concurrently, human-animal interaction activities also showed variations across different COVID-19 phases. The association between human-animal interactions and the occurrence of behavior problems underscored the importance of not only exercise quantity but also adherence to consistent schedules, particularly for dogs, in mitigating behavior problems. Interestingly, among cats, sleeping outside the bedroom was associated with a reduced occurrence of aggression, anxiety, fear, and physiological behavior changes. However, sleep location displayed limited or no association with behavior problems in dogs. In summary, this study highlights the importance of tailoring interventions to the unique needs of each species through human-animal interactions to mitigate the occurrence of behavioral problems and enhance human-animal relationships.

"Things changed very quickly": Maternal intentions and decision-making about infant sleep surface, location, and position.

Approximately 3400 infants die suddenly and unexpectedly each year in the United States; many of these deaths include modifiable risk factors (such as a non-supine position, sleeping on a soft surface, or loose bedding or items in the environment). Interventions have been successful at improving parental knowledge about recommendations to reduce risk of sleep-related infant deaths, as well as improving intention to adopt recommendations. However, follow-up studies have found a disconnect between knowledge/intentions to adhere to recommendations and actual practices. Exploring maternal decision-making about infant sleep practices can better elucidate the disconnect between knowledge of infant sleep recommendations and the practice of it, and thus, inform more effective safe sleep interventions. The purpose of this study was to gain a more in-depth understanding of decision-making around infant sleep practices, and barriers and facilitators to adopting safe infant sleep recommendations. Semi-structured in-home interviews were conducted with 22 families (20 mothers and 2 mother-father dyads) of infants up to 6 months of age. Thematic analysis of the transcripts revealed six themes: Plans changed when baby came, Trying things to figure out what works (infant preferences), Safety concerns, What's comfortable for me (maternal preferences), They say…(advice), and Trying to be careful. These results suggest that knowledge of infant sleep recommendations alone is not enough to ensure adherence and that decision-making is a dynamic and ongoing process affected by multiple factors. Findings have implications for timing and content of risk reduction efforts, as well as for data collection in research studies.

Understanding motivations and satisfaction with sleep location among co‐sleeping (including bed‐sharing) parents

AbstractObjectiveThe study objective was to understand intentions, sleep location preferences, and satisfaction with co‐sleeping (including bed‐sharing) arrangements in an internet‐based sample of self‐identified co‐sleeping parents.BackgroundWestern‐centric ideologies favor independent, self‐regulated, and consolidated sleep. Safe‐sleep recommendations advise against all forms of parent–child bed‐sharing while promoting room‐sharing. Co‐sleeping including bed‐sharing and room‐sharing is widely practiced globally and rates continue to increase in Western countries. Yet perspectives of co‐sleeping parents remain under‐researched.MethodA cross‐sectional study design was used to understand co‐sleeping parents' (n = 3,146) intentions, preferences, and satisfaction with co‐sleeping (room‐sharing and bed‐sharing) choices through a survey.ResultsCo‐sleeping practices were nuanced and varied with parents and children transitioning between sleep location and surfaces through the night. Although 64% of parents did not intend to co‐sleep before the birth of their child, 88% preferred the current co‐sleeping location, and 81% indicated satisfaction with it. Parental intention to co‐sleep (including bed‐share) was related to satisfaction with the arrangement. Parents who did not prefer any co‐sleeping arrangement at the current time were likely to be parenting older children. A thematic analysis yielded themes relating to the motivations underlying intent and preference, as well as reluctance and dissatisfaction with co‐sleeping arrangements.ConclusionCo‐sleeping including bed‐sharing continues to be practiced by parents in Western countries. Despite a lack of intent to engage with co‐sleeping including bed‐sharing, the majority of the parents in this sample were bed‐sharing with their infants and young children. Parents choose to room‐share and bed‐share for a range of reasons.ImplicationsParents voices highlight the need for safe co‐sleeping including bed‐sharing education. Considerations must be given to parents' perspectives in implementing nighttime infant care practices, including facilitating collaborative discussions with parents to assess and minimize potential risks associated with bed‐sharing.

94 Understanding Parental Behaviours Related to Infant Sleep Environment

Abstract Introduction/Background Sudden unexplained death in infants continues to make up a significant proportion of infant deaths. Despite wide dissemination of Canadian Paediatric Society and American Academy of Paediatrics safe sleep recommendations, studies demonstrate significant caregiver nonadherence to the recommendations. Few studies have examined caregiver reasons for low uptake of recommendations. There is an urgent need to understand these issues not only for individual providers counseling about sleep, but also for implementation of public health initiatives which attempt to target parental behaviour change. Objectives Our study aimed to explore parental perceptions, beliefs and influences regarding safe infant sleep environment and factors contributing to parental behaviour related to sleep environment. Design/Methods A qualitative study utilizing ground theory methodology was conducted with in-depth individual interviews of 14 parents of infants less than six months admitted to a large paediatric hospital in Toronto, Canada. Data collection occurred from November 2017 to January 2018, until a saturation of themes was reached. Interview transcripts were analyzed for recurrent and emergent themes and a coding structure was developed. Results Interviews with caregivers were completed, and a range of sleep locations and environments were described. Most caregivers reported that a bassinet or crib was the main sleeping location, but most infants were also placed in other locations at various times, including infant swings, couches, and bed-sharing with caregivers. Three dominant themes affecting decision-making about sleep location were identified: 1. safety, 2. feasibility and convenience and, 3. perception of infant preference and developmental needs. These factors were often present simultaneously in parental decision-making, frequently acting in opposition to one another. Caregivers’ methods of mitigating harm were often counter to recommendations, such as using pillows to prevent rolling. Information sources regarding sleep choices typically included family, friends, healthcare providers and media. Most caregivers placed greater significance on healthcare recommendations than the advice of family members. Conclusion This study identified key factors that impact caregivers’ decision-making regarding infant sleep. These results can inform healthcare providers counselling about safe sleep recommendations and public health interventions aimed at increasing adherence to safe sleep recommendations and reducing preventable infant deaths.

Somatostatin neurons in prefrontal cortex initiate sleep-preparatory behavior and sleep via the preoptic and lateral hypothalamus

The prefrontal cortex (PFC) enables mammals to respond to situations, including internal states, with appropriate actions. One such internal state could be ‘tiredness’. Here, using activity tagging in the mouse PFC, we identified particularly excitable, fast-spiking, somatostatin-expressing, γ-aminobutyric acid (GABA) (PFCSst-GABA) cells that responded to sleep deprivation. These cells projected to the lateral preoptic (LPO) hypothalamus and the lateral hypothalamus (LH). Stimulating PFCSst-GABA terminals in the LPO hypothalamus caused sleep-preparatory behavior (nesting, elevated theta power and elevated temperature), and stimulating PFCSst-GABA terminals in the LH mimicked recovery sleep (non-rapid eye-movement sleep with higher delta power and lower body temperature). PFCSst-GABA terminals had enhanced activity during nesting and sleep, inducing inhibitory postsynaptic currents on diverse cells in the LPO hypothalamus and the LH. The PFC also might feature in deciding sleep location in the absence of excessive fatigue. These findings suggest that the PFC instructs the hypothalamus to ensure that optimal sleep takes place in a suitable place.

Guardians' perceptions of caring for a dog with canine cognitive dysfunction.

Canine cognitive dysfunction (CCD) is a neurodegenerative disease that is difficult to diagnose, as its clinical signs are similar to those of other age-related conditions. The experience of caring for a senior dog with or without CCD is not well described. Data were collected via an online survey. Using a mixed methods design, the level of CCD and burden of care were measured using validated tools, and open-ended questions gathered qualitative data. A general linear model showed the factors associated with guardian burden of care. Sixteen percent of guardians experienced a clinically significant burden of care. Factors associated with burden of care included severity of CCD, sleep location, guardian employment, household size, dog age, guardian age and the dog taking medication. Few dogs with CCD were prescribed CCD medications to ameliorate clinical signs. Euthanasia, strong attachment mitigating burden and the complexities of caregiving were themes presented by guardians. Measures are based on self-reports and as such the usual limitations apply. The burden of caring for an older dog is greater if they have CCD. More attention to the treatment of senior dogs, including medications to reduce clinical signs of CCD, could improve the welfare of older dogs and decrease the clinical burden experienced by guardians.

Homelessness in the district of Nipissing of Ontario, Canada before, at the onset and during the COVID-19 pandemic: a trend analysis (2018–2021)

BackgroundHomelessness is a growing social concern experienced across Canada. In Ontario, specifically in the District of Nipissing, the issue has become larger with an increasing number of homeless individuals. Previous research has described the demographic composition of the homeless population both in the Nipissing District of Ontario and in the city of North Bay. However, no studies have examined homelessness in this region before, at the beginning and during the COVID-19 pandemic. This research investigates structural and individual-level barriers and factors that are associated with becoming homeless or remaining homeless.MethodsThis study utilizes data from the 2018 (n = 147), 2020 (n = 254), and 2021 (n = 207) homelessness enumeration surveys, conducted in the District of Nipissing, Ontario by the District of Nipissing Social Services Administration Board. This study employs quantitative, descriptive analyses to examine trends and socio-demographic variations in the reasons of homelessness, barriers to housing, episodic and chronic homelessness before, at the beginning, and during the COVID-19 pandemic.ResultsThe results revealed a rise in the proportion of male homeless (57% vs. 64%), and first-time homelessness among those aged 35–44 (3%, vs. 15%) and 55–64 (1% vs. 5%) at the onset and during the pandemic. The sleep location of homeless individuals was also influenced by the pandemic, where emergency shelter use dropped to half during 2020–2021(33% vs. 17%), while the use of locations (hotel/motels) where proper pandemic protocols and social distancing were possible increased sharply from 2 to 12% of homeless individuals. With the onset of the pandemic, chronic homelessness and one-episodic homelessness increased, suggesting that individuals are becoming homeless and staying homeless for prolonged periods. The barriers to housing during the pandemic were largely addiction, substance use and the inaccessibility of safe and secure rental units, while the corresponding barriers before the pandemic were mainly low income.ConclusionsThe rise in male homelessness, age at first-time homelessness and interpersonal conflict causing homelessness at the onset and during the pandemic suggest that policy makers need to focus on providing homeless supports to these groups of homeless populations at the time of pandemic.

Fetal SSRI antidepressant exposure and infant sleep: Findings from the MPEWS pregnancy cohort study

This longitudinal study examines the association between fetal Selective Serotonergic Reuptake Inhibitor antidepressant exposure and infant sleep behaviours at six and 12 months of age and focus on three of the most commonly prescribed antidepressants in pregnancy.This study utilises data on 698 women recruited at less than 20 weeks of pregnancy and are followed up at six and 12 months postpartum. Women were recruited into one of three groups: those taking either sertraline, citalopram or escitalopram antidepressants in pregnancy (n = 85); women with a depressive disorder who were not taking antidepressants (non-medicated depressed, NMD; n = 82); and, and a control group of women (n = 531). At six and 12 months, data were collected on breastfeeding and sleep location and infant sleep was measured using the Brief Infant Sleep Questionnaire. Antidepressants sertraline, escitalopram and citalopram were not associated with increased infant waking or time awake. However, sertraline was associated with longer time for an infant to go to sleep.This study provides reassurance that SSRI antidepressants and, in particular, sertraline, escitalopram and citalopram are not associated with infant sleep behaviours that are commonly regarded as problematic including night waking. Further replication of these findings, including with direct measures of infant sleep, are recommended.

COVID-19 Impact on Group Prenatal Education: A Comparison of Virtual and In-Person Formats.

This retrospective study compared knowledge, intention, and satisfaction outcomes between pregnant women who attended prenatal education in person (n = 202; 55%) prior to the COVID-19 pandemic or virtually (n = 166; 45%) during the pandemic. Results identified increases in knowledge and intention for a healthy pregnancy and safe infant care for both groups. Virtual participants were less likely to endorse developing a birth plan (p = 0.035), knowledge of breastfeeding resources (p = 0.006), confidence in the ability to breastfeed (p = 0.033), and plans to use only a safe infant sleep location (p = 0.045). Important education was provided by continuing Baby Talk during the pandemic. However, topics with activities/demonstrations during in-person learning that were discontinued for virtual learning had significantly lower increases for virtual participants. Virtual education should incorporate more demonstrations/activities.