Sleep Location Research Articles

Travel fatigue and sleep/wake behaviors of professional soccer players during international competition

ObjectiveThe magnitude of travel completed by professional Australian soccer teams during domestic competition is substantial. The inclusion of Australian soccer teams into the Asian Champions league has seen additional stress placed on soccer players' training and competition schedules. For management staff, the complexity of organizing training and travel schedules during domestic competition and the Asian Champions league is challenging. DesignCase study. ParticipantsSeven male professional soccer players (mean ± SD: age 25.2 ± 3.2 years, height 182.8 ± 5.2 cm, body mass 84.6 ± 7.4 kg). MeasurementsThis study examined the sleep and fatigue levels of Australian soccer players during an intensive home and away travel schedule during the Asian Champions league. Seven male professional soccer players’ (mean ± SD: age 25.2 ± 3.2 years, height 182.8 ± 5.2 cm, body mass 84.6 ± 7.4 kg) sleep/wake behavior was assessed using sleep diaries and wrist activity monitors for 19 days, including 9 days before, 5 days during, and 4 days after a home and away group stage match of the Asian Champions league. Analyses examined differences in sleep/wake behavior and fatigue levels between day type (training day, rest day, pregame, and postgame) and between sleep location (Adelaide, during flight, and Hiroshima). ResultsSleep/wake behavior and fatigue levels were poorest the night immediately after games compared to the night before games, training days, and rest days. Soccer players' sleep/wake behaviors were disrupted during flights such that they obtained 3.6 hours less sleep during flights compared to sleep in Adelaide (7.0 ± 1.6 hours) and Hiroshima (7.0 ± 2.1 hours). ConclusionThe sleep/wake behaviors of professional soccer players are compromised when they are required to travel and compete in multiple matches within a short period of time.

The Impact of Feeding Method and Infant Sleep Location on Mother/Infant Sleep, Maternal Depression, and Mothers’ Well-Being

Previous studies have found that exclusively breastfeeding (EBF) mothers get more sleep and report higher levels of well-being than mothers who are not EBF. We do not know whether infant sleep location influences these findings. The present analyses are from the Survey of Mothers’ Sleep and Fatigue, an online survey of 6,410 mothers from 59 countries. Feeding method and sleep location do interact and are related to babies’ and mothers’ sleep and measures of mothers’ well-being. EBF/bedsharing mothers reported more sleep, better physical health, and less depression, anger, and anxiety than non-EBF or nonbedsharing mothers. Conversely, bedsharing/non-EBF mothers had some of the worst outcomes. Bedsharing was related to positive outcomes for EBF mothers. Our findings are consistent with recommendations that non-EBF mothers avoid bedsharing.

Discrepancies in maternal reports of infant sleep vs. actigraphy by mode of feeding

ObjectivesMany studies of infant sleep rely solely on parentally-reported data, assuming that parents accurately report their infant's sleep parameters. The objective of this paper is to examine whether night-time sleep parameters of exclusively breastfed or exclusively formula-fed infants differ, and whether correspondence between parental reports and objective measures varies by feeding type. MethodsMother-infant dyads intending to breastfeed or formula-feed exclusively for 18 weeks were recruited. Mothers were multiparas and primiparas, aged between 18 and 45 years. Infants were full-term, normal birthweight singletons. Maternal report and actigraphic data on infant sleep were collected fortnightly, from four to 18 weeks postpartum. Data were analysed cross-sectionally using t-tests and GLM analysis to control for interaction between feed-type and sleep location. ResultsActigraphy-assessed infant sleep parameters did not vary by feed-type but parentally reported sleep parameters did. Maternal report and actigraphy data diverged at 10 weeks postpartum and discrepancies were associated with infant feeding type. Compared to actigraphy, maternal reports by formula-feeding mothers (controlling for infant sleep location) over-estimated infant's Total Sleep Time (TST) at 10 weeks and Longest Sleep Period (LSP) at 10, 12 and 18 weeks. ConclusionsThese results raise questions about the outcomes of previous infant sleep studies where accuracy of parentally-reported infant sleep data is assumed. That parental reports of infant sleep vary by feeding type is particularly important for reconsidering previous studies of infant sleep development and intervention studies designed to influence sleep outcomes, especially where feed-type was heterogeneous, but was not considered as an independent variable.

Differences in pre-sleep activity and sleep location are associated with variability in daytime/nighttime sleep electrophysiology in the domestic dog

The domestic dog (Canis familiaris) is a promising animal model. Yet, the canine neuroscience literature is predominantly comprised of studies wherein (semi-)invasive methods and intensive training are used to study awake dog behavior. Given prior findings with humans and/or dogs, our goal was to assess, in 16 family dogs (1.5–7 years old; 10 males; 10 different breeds) the effects of pre-sleep activity and timing and location of sleep on sleep electrophysiology. All three factors had a main and/or interactive effect on sleep macrostructure. Following an active day, dogs slept more, were more likely to have an earlier drowsiness and NREM, and spent less time in drowsiness and more time in NREM and REM. Activity also had location- and time of day-specific effects. Time of day had main effects; at nighttime, dogs slept more and spent less time in drowsiness and awake after first drowsiness, and more time in NREM and in REM. Location had a main effect; when not at home, REM sleep following a first NREM was less likely. Findings are consistent with and extend prior human and dog data and have implications for the dog as an animal model and for informing future comparative research on sleep.

0821 Infant Sleep Location and Association with Maternal and Infant Sleep in Latina and Non-Latina Families

0821 Infant Sleep Location and Association with Maternal and Infant Sleep in Latina and Non-Latina Families

Characteristics of Infant Deaths during Sleep While Under Nonparental Supervision

To compare risk factors for infant sleep-related deaths under the supervision of parents and nonparents. We conducted a secondary analysis of sleep-related infant deaths from 2004 to 2014 in the National Center for Fatality Review and Prevention Child Death Review Case Reporting System. The main exposure was supervisor at time of death. Primary outcomes included sleep position, location, and objects in the environment. Risk factors for parental vs nonparental supervisor were compared using χ2 and multivariable logistic regression models. Risk factors associated with different nonparental supervisors were analyzed using χ2. Of the 10 490 deaths, 1375 (13.1%) occurred under nonparental supervision. Infants who died under nonparental supervision had higher adjusted odds of dying outside the home (OR 12.87, 95% CI 11.31-14.65), being placed prone (OR 1.61, 95% CI 1.39-1.86) or on their side (OR 1.35, 95% CI 1.12-1.62), or being found prone (OR 1.74, 95% CI 1.50-2.02). Among infants who died under nonparental supervision, those supervised by relatives or friends were more often placed on an adult bed or couch for sleep and bed sharing (P < .0001), and to have objects in the sleep environment (P = .01). Infants who died of sleep-related causes under nonparental supervision were more likely to have been placed nonsupine. Among nonparental supervisors, relatives and friends were more likely to use unsafe sleep environments, such as locations other than a crib or bassinet and bed sharing. Pediatricians should educate parents that all caregivers must always follow safe sleep practices.

Bed-Sharing in the First 8 Weeks of Life: An Australian Study.

Background As the evidence continues to emerge about the relationship between sudden unexpected death in infancy (SUDI) and the way an infant sleeps, providing consistent and evidence-informed recommendations on how best to sleep infants is an ongoing challenge. A recent case series study in the state of Victoria, Australia, identified 45.8% of sleep-related infant deaths occurred whilst bed-sharing. This study prompted the need for further exploration of infant sleeping practices, including bed-sharing, in this population. Methods A cross-sectional survey of 2745 mothers attending the Maternal and Child Health (MCH) Service across Victoria, Australia was conducted. Data included the prevalence and circumstances of bed-sharing, family demographics, and SUDI risk and protective factors. Associations between bed-sharing and SUDI risk and protective factors were examined using univariate and multivariate analyses. Results Bed-sharing prevalence was found to be 44.7%, with 21.5% reporting that this was intended. Multivariate analyses showed bed-sharing was less likely amongst those with an annual household income above $AUS104, 000 (OR 0.72; 95% CI 0.54-0.96) and more likely amongst mothers who breastfed (OR 1.71; 95% CI 1.23-2.37). Conclusions Bed-sharing prevalence in this population compares closely with the Victorian case series study and a previous cross-sectional study in the state of Queensland, Australia, in 2002. Noted gaps in how families are implementing current recommendations about reducing the risk of SUDI were identified for sleep position, sleep location and the sleep environment. Further consideration needs to be given to addressing these gaps and applying these findings of current bed-sharing practices to the development of infant safe sleeping policy and programs.

Intensity of exposure to pulmonary tuberculosis determines risk of tuberculosis infection and disease.

Household contacts of pulmonary tuberculosis (TB) patients are at increased risk of TB infection and disease. However, their risk in relation to the intensity of exposure remains unknown.We studied smear-positive TB cases and their household contacts in Vitória, Brazil. We collected clinical, demographic and radiographic information from TB cases, and obtained tuberculin skin test (TST) and QuantiFERON-TB Gold (QFT) results from household contacts. We measured intensity of exposure using a proximity score and sleep location in relation to the TB index case and defined infection by TST ≥10 mm or QFT ≥0.35 UI·mL-1 We ascertained secondary TB cases by reviewing local and nationwide case registries.We included 160 TB index cases and 894 household contacts. 464 (65%) had TB infection and 23 (2.6%) developed TB disease. Risk of TB infection and disease increased with more intense exposures. In an adjusted analysis, the proximity score was associated with TB disease (OR 1.61, 95% CI 1.25-2.08; p<0.000); however, its diagnostic performance was only moderate.Intensity of exposure increased risk of TB infection and disease among household contacts; however, its diagnostic performance was still suboptimal. A biomarker to target preventive therapy is urgently needed in this at-risk population.

A Statewide Hospital-Based Safe Infant Sleep Initiative: Measurement of Parental Knowledge and Behavior

Sleep-related infant deaths are a leading cause of infant mortality in Georgia, and these deaths are largely associated with unsafe sleep practices among caregivers. In early 2016, the Georgia Department of Public Health launched the Georgia Safe to Sleep Hospital Initiative, providing hospitals with safe infant sleep information and educational materials to be distributed to families and newborns. This study examined the knowledge and behaviors of a sample of Georgia parents after the implementation of the Hospital Initiative and identified the family characteristics and intervention components most closely associated with the knowledge and practice of safe infant sleep. The primary caretakers of all infants born in Georgia from August to October 2016 were invited to complete a web-based survey 1 month after hospital discharge. The final sample size included 420 parents of newborns, and the primary outcomes assessed included two measures of knowledge and four measures of infant sleep behaviors regarding infant sleep position and location. Most respondents demonstrated knowledge of the correct recommended sleep position (90%) and location (85%). Logistic regression revealed that receipt of information in the hospital was significantly correlated with safe sleep behaviors, and infant sleep habits tended to influence safe sleep practices. Additionally, Medicaid parents receiving bassinets from the hospital were 74% less likely to bed share (OR 0.26; 95% CI 0.007). Implementation of a statewide hospital initiative was associated with high levels of parental knowledge and behavior and may have been successful in reducing the practice of bed sharing among Medicaid parents.

Sleep location and parent-perceived sleep outcomes in older infants

ObjectivesInitial studies indicate more independent and consolidated sleep in the first few months in infants who sleep separately. Little is known, however, about the relationship of sleep location (separate room, room-sharing, bed-sharing) with sleep outcomes in older infants (ages 6–12 months). It was expected that those who sleep in a separate room would have better parent-perceived sleep outcomes and more positive sleep health behaviors. MethodsParents of 6236 infants (6–12 months) in the United States (US) and 3798 in an international sample (Australia, Brazil, Canada, Great Britain, and New Zealand) completed a smartphone app-based expanded version of the validated Brief Infant Sleep Questionnaire. ResultsA total of 37.2% of the infants in the US and 48.4% in the international sample slept in a separate room. In both samples, infants who slept in a separate room as opposed to room-sharing or bed-sharing had parent-perceived sleep outcomes and sleep-related behaviors that reflected earlier bedtimes, shorter time to fall asleep, more nighttime and total sleep, and increased sleep consolidation. They were also more likely to have a consistent bedtime routine and to fall asleep independently, as well as less likely to feed to sleep at bedtime and during the night. In addition, parents of separate room sleepers perceived bedtime to be less difficult and sleep to be better overall. ConclusionsOverall, 6- to 12-month-old infants who slept in a separate room had better reported sleep outcomes and fewer parent-perceived disturbances at bedtime than infants who room-shared with their parents, as well compared to those who slept in their parents' bed.

0915 SELF-REPORTED SLEEP BEHAVIORS AND SLEEP DISTURBANCES IN ADOLESCENTS WITH AND WITHOUT ASTHMA

Asthma impacts approximately 10% of adolescents. Youth with asthma are at risk for increased sleep disturbance, even when their asthma is well-controlled. However, only a small number of studies have examined sleep behaviors in addition to sleep disturbances in adolescents with asthma. The purpose of this study was to examine self-reported sleep behaviors and sleep disturbances in adolescents with and without asthma. Participants were 58 adolescents with asthma (50% female, mean age=14.5, range 12–18) and 58 adolescents without asthma (50% female, mean age=14.5, range 13–18). Participants completed the Children’s Report of Sleep Patterns (CRSP), which provides information about self-reported napping frequency, sleep quality, as well as sleep location (e.g., falling asleep with a parent present or in a siblings room), and generates scores for Bedtime Fears/Worries, Insomnia, and Daytime Sleepiness. Adolescents with asthma reported less independent sleeping compared to adolescents without asthma, t(113)=3.17, p=.002. While no difference was found between adolescents with or without asthma in terms of insomnia symptoms, t(114)=.08, p=.94, adolescents with asthma did report more frequent worries and fears at bedtime compared to adolescents without asthma, t(114)=9.26, p<.001. Adolescents with asthma reported increased daytime sleepiness compared to those without asthma, t(114)=1.88, p=.06, which was also reflected in the increased napping frequency reported by adolescents with asthma, with 51.7% taking naps sometimes or every day, compared to only 17.2% of adolescents without asthma χ2 (2)=16.34, p <.001. Notably, adolescents with and without asthma did not differ on self-reported sleep quality χ2 (1)=1.55, p=.21. The results from this study highlight increased daytime sleepiness and more frequent napping in adolescents with asthma. In addition, in this study adolescents with asthma had more fears and worries at bedtime, as well as less independent sleeping. More research is needed to determine the contribution of asthma to both nighttime worries and daytime sleepiness. NIH grant R01 HL119441

0913 EXPLORING SLEEP DISTURBANCE AMONG FAMILY CAREGIVERS OF CHILDREN WITH MEDICAL COMPLEXITY

Family caregivers of children with complex care needs that depend on medical technology (e.g. home ventilation) are relied upon to provide skillful, vigilant homecare 24-hours/day. This responsibility has been linked to chronic sleep disturbance, placing family caregivers at risk of poor health outcomes. To inform testing of a sleep promoting intervention, the following questions have guided this research: What factors influence sleep among family caregivers? How do family caregivers appraise the utility of sleep-promoting interventions? To what degree do family caregivers perceive sleep and related health outcomes as problematic? A multi-site cross-sectional observational design using mixed data sources is underway. Participants include family caregivers with a child dependent on medical technology at night, > 3 months homecare experience and no diagnosed sleep disorders. Interviews have been completed for qualitative content analysis. Quantitative measures administered include: Q- sort using images/text depicting sleep-promoting interventions; Scale of the Problem to measure participant’s appraisal of their sleep/health on a unipolar Likert scale ranging from 0 to 4. Nine participants have completed study procedures with further sample diversification planned. Emerging qualitative themes include: 1) caregiver (vigilance/worries, mood/emotions, sleep habits, parenting preferences), 2) child (age/development, equipment use, sleep quality, care needs), 3) family (financial/household stressors, other child-care, employment demands), 4) environment (lights/noises, personal technologies, housing, sleep location); and, 5) homecare (presence of night nursing, provider competence, family-centred service, resource constraints). To date, participants rank mindfulness/yoga (7/9), brief daily-exercise (6/9) and enhanced use of respite (6/9) their ‘top choices’ among evidence-based interventions. Moreover, family caregivers appraise their sleep quality (3.2/4), daily stress (3.2/4), sleep quantity (3.0/4) and fatigue (3.0/4) to be problematic. Findings suggest multiple factors contribute to poor quality and inadequate quantity of sleep among family caregivers when a child is medically complex. Family caregivers assign value to addressing sleep problems and support testing of evidence-based sleep promoting interventions with demonstrated effectiveness in other caregiver (older-adult) populations. Funding for the study is gratefully acknowledged from the SickKids Foundation and Holland Bloorview Research Institute.

Parental behaviors and sleep/wake patterns of infants and toddlers in Hong Kong, China.

To describe the sleep patterns of children below 36 months in Hong Kong, and evaluate the associations between parental behaviors and childhood sleep/wake patterns. Parents of 1049 infants and toddlers completed an internet-based expanded version of the Brief Infant Sleep Questionnaire. Total sleep duration (P<0.001), frequency (P<0.001) and duration (P<0.001) of nocturnal awakenings decreased with age, whereas the longest sleep duration (P<0.001) and nocturnal sleep duration (P<0.001) increased with age. Children who room- or bed-shared with parents had later bedtimes (P<0.001), but similar sleep duration compared with those who had a separate sleep location. Falling asleep independently was associated with longer nocturnal sleep duration (P<0.001) and less sleep awakenings (P<0.001). Full-time employment of parents was associated with shorter total sleep duration of children (P<0.001). Although breastfeeding was associated with more nocturnal awakenings (P<0.001), no association was detected between breastfeeding and shorter sleep duration in children. As infants and toddlers develop, their sleep consolidates. Falling asleep independently was associated with longer nocturnal sleep duration and fewer sleep awakenings, whereas sleep location was not. This is an important finding, especially for families with limited living space where parent/child room- or bed-sharing cannot be avoided.

Psychological Outcomes in Parents of Critically Ill Hospitalized Children

Parents of children in pediatric intensive care units (PICUs) are subjected to significant psychological stress. The purpose of this study was to determine the prevalence of, and factors associated with anxiety, depressive symptoms and decisional conflict in parents of children hospitalized in the PICU. The study employed a descriptive, cross-sectional design to investigate the psychological status of 118 parents of 91 children (74 mothers and 44 fathers) admitted to the PICU, using measures of anxiety (STAI), depression (CES-D), and decisional conflict (DCS). Using hospital data and self-administered questionnaires, information on child and parent characteristics and psychological outcomes were collected. Objective measures of parental sleep also were examined using actigraphy and sleep diaries. The research findings indicated that 24% of parents achieved scores characteristic of severe anxiety. Proportions of parents with symptoms indicative of major depression and significant decisional conflict were 51% and 26% respectively. For all psychological outcomes, higher levels of social support were protective. Inconsistency in sleep schedule and sleep location affected psychological outcomes and are possible targets for future interventions. Given evidence that parents of children admitted to the PICU are at risk for developing post-traumatic stress symptoms, future studies should examine the effects of hospitalization on long-term parental psychological outcomes. Screening for those at risk and implementing interventions to promote coping strategies and reduce decisional conflict may be beneficial. Pediatric nurses have a critical role in assessing parents' psychological distress and promoting family health during a child's hospitalization.

Wahakura Versus Bassinet for Safe Infant Sleep: A Randomized Trial.

To compare an indigenous sleep device (wahakura) for infants at high risk for sudden unexpected death with a bassinet, for measures of infant sleep position, head covering, breastfeeding, bed-sharing, and maternal sleep and fatigue. A total of 200 mainly Māori pregnant women were recruited from deprived areas of New Zealand. They were randomized to receive a bassinet or wahakura and asked to sleep the infant in this device from birth. Questionnaires at 1, 3, and 6 months and an overnight infrared video in the home at 1 month were completed. An intention-to-treat and an "as-used" analysis of questionnaires showed no group differences at 1, 3, and 6 months in infant-adult direct bed-sharing (7% vs 12%, P = .24 at 1 month), and at the 6-month interview, the wahakura group reported twice the level of full breastfeeding (22.5% vs 10.7%, P = .04). Maternal sleep and fatigue were not significantly different between groups. Video identified no increase in head covering, prone/side sleep position, or bed-sharing in the wahakura group, either from intention-to-treat analysis, or when analyzed for actual sleep location. There were no significant differences in infant risk behaviors in wahakura compared with bassinets and there were other advantages, including an increase in sustained breastfeeding. This suggests wahakura are relatively safe and can be promoted as an alternative to infant-adult bed-sharing. Policies that encourage utilization are likely to be helpful in high-risk populations.

Parent decision factors, safety strategies, and fears about infant sleep locations

Infant sleep safety is a primary concern of parents. Infant sleep locations vary around the world. Purpose: This pilot study investigated the decision factors, fears, and safety strategies reported by parents internationally. Methods: participants (n=49) recruited online from 10 countries completed an anonymous Internet survey in English and submitted a picture of the infant's primary nighttime sleep location. Pictures were coded into ‘shared’ (29%) or ‘separate’ (71%) sleep surfaces. Results: primary decision factors about infant sleep location were safety, comfort, family sleep quality, and overall ease. Parents maximized safety by providing a clear sleep surface, no blankets, no toys, sleep sack use, and a firm mattress. Different worries and fears emerged depending on the sleep surface. Conclusion: differences in the specific worries and strategies used by parents when deciding whether to share or not share a sleep surface with an infant may be used to tailor future interventions.

Impact of a Randomized Controlled Trial to Reduce Bedsharing on Breastfeeding Rates and Duration for African-American Infants.

Bedsharing is associated with both increased breastfeeding and increased risk of sudden and unexpected infant deaths. The objective was to determine impact of sleep location and counseling about sleep location on breastfeeding exclusivity and duration in African-Americans. 1194 mothers of newborns were randomized to receive messaging emphasizing either safe sleep practices to reduce SIDS risk or safe sleep practices to prevent SIDS/suffocation. Mothers completed four interviews in the 6months after delivery. The most common sleep arrangement was roomsharing without bedsharing ("roomsharing"). Duration of any breastfeeding was 6.1 and 5.3weeks for infants who usually bedshared or roomshared, respectively (p = 0.01). Duration of exclusive breastfeeding was 3.0 and 1.6weeks for infants who usually bedshared or roomshared, respectively (p < 0.001). Group assignment did not affect breastfeeding duration. The most common sleep arrangement for African-American infants <6 months was roomsharing. An intervention designed to discourage bedsharing did not impact breastfeeding duration.

Factors Associated With Infant Bed-Sharing.

Objective: Bed-sharing is associated with sudden infant death syndrome and accidental suffocation and strangulation in bed. The purpose of this study was to identify risk factors for newborn bed-sharing. Methods: Postpartum mothers from a university maternity service were contacted by phone to complete a survey. Demographic and environmental data were collected; newborn bed-sharing and sleep environment were self-reported. Results: A total of 1261 mothers completed surveys; bed-sharing was reported by 79 mothers (6.3%). Multivariate logistic regression identified referral to a nurse (odds ratio [OR] = 10; 95% confidence interval [CI] = 4.5-30) and sleep location “other” than a crib, bassinet, or Pack and Play (OR = 7.1; 95% CI = 1.9-25.9) as factors associated with an increased risk of bed-sharing; formula feeding (OR = 0.4; 95% CI = 0.20-0.77) and crib sleeping (OR = 0.49; 95% CI = 0.26-0.86) reduced this risk. Conclusion: Infants with no identifiable places to sleep, significant health issues, and who are breastfed are more likely to bed-share. Interventional studies should be directed at these factors.

Differences in Infant Care Practices and Smoking among Hispanic Mothers Living in the United States

To assess the association between maternal birth country and adherence to the American Academy of Pediatrics safe sleep recommendations in a national sample of Hispanic mothers, given that data assessing the heterogeneity of infant care practices among Hispanics are lacking. We used a stratified, 2-stage, clustered design to obtain a nationally representative sample of mothers from 32 US intrapartum hospitals. A total of 907 completed follow-up surveys (administered 2-6 months postpartum) were received from mothers who self-identified as Hispanic/Latina, forming our sample, which we divided into 4 subpopulations by birth country (US, Mexico, Central/South America, and Caribbean). Prevalence estimates and aORs were determined for infant sleep position, location, breastfeeding, and maternal smoking. When compared with US-born mothers, we found that mothers born in the Caribbean (aOR 4.56) and Central/South America (aOR 2.68) were significantly more likely to room share without bed sharing. Caribbean-born mothers were significantly less likely to place infants to sleep supine (aOR 0.41). Mothers born in Mexico (aOR 1.67) and Central/South America (aOR 2.57) were significantly more likely to exclusively breastfeed; Caribbean-born mothers (aOR 0.13) were significantly less likely to do so. Foreign-born mothers were significantly less likely to smoke before and during pregnancy. Among US Hispanics, adherence to American Academy of Pediatrics safe sleep recommendations varies widely by maternal birth country. These data illustrate the importance of examining behavioral heterogeneity among ethnic groups and have potential relevance for developing targeted interventions for safe infant sleep.

Infant Sleep Environments

Research Article| November 01 2016 Infant Sleep Environments AAP Grand Rounds (2016) 36 (5): 55. https://doi.org/10.1542/gr.36-5-55 Views Icon Views Article contents Figures & tables Video Audio Supplementary Data Peer Review Share Icon Share Facebook Twitter LinkedIn MailTo Tools Icon Tools Get Permissions Cite Icon Cite Search Site Citation Infant Sleep Environments. AAP Grand Rounds November 2016; 36 (5): 55. https://doi.org/10.1542/gr.36-5-55 Download citation file: Ris (Zotero) Reference Manager EasyBib Bookends Mendeley Papers EndNote RefWorks BibTex toolbar search toolbar search search input Search input auto suggest filter your search All PublicationsAll JournalsAAP Grand RoundsPediatricsHospital PediatricsPediatrics In ReviewNeoReviewsAAP NewsAll AAP Sites Search Advanced Search Topics: sleep Source: Batra EK, Teti DM, Schaefer EW, et al. Nocturnal video assessment of infant sleep environments. Pediatrics. 2016; 138(3): e20161533;doi: https://doi.org/10.1542/peds.2016-1533Google Scholar Investigators at Penn State University videotaped sleeping infants within family homes to determine the frequency of known environmental risk behaviors for sleep-related infant death (SIDS). Mothers were approached 48 hours after the birth of their newborn, and completed a demographic questionnaire at enrollment. When their infant was 1, 3, and 6 months old, study staff visited each parent participant’s home to set up video equipment in the areas of the home where the infant commonly slept. Videotaping occurred for a single night at each of the 3 infant ages. Videotapes were then subsequently coded for 4 variables: (1) sleep surface (AAP-recommended sleep surface [crib, cradle, bassinet, playpen] versus non-recommended surface [adult bed, sofa, car seat, co-sleeper, or swing]), (2) sleep location (parent room, own room, other), (3) sleep position (supine, side, prone, indeterminate), and (4) presence of non-recommended loose items on or around the sleep surface (loose bedding, bumper pad, stuffed animal). Of 167 participants enrolled, 162 had at least 1 videotape and were included in analysis; 147 had videotapes from all 3 time-points. Most parent participants were white, married, and had at least some college education. At 1, 3, and 6 months, 21%, 10%, and 12% of infants, respectively, were initially put to bed on non-recommended sleep surfaces; 14%, 18%, and 33% were placed in non-supine positions; and 91%, 87%, and 93% were surrounded by non-recommended loose items on the sleep surface. Among 1-month-old infants, 28% slept in at least 2 locations during the night, with 36% placed in a non-supine position at the second location and 67% sharing the sleep surface of the second location with another person. Among the 18% of 3 month olds and 12% of 6 month olds who slept in 2 locations during the night, 67% and 78% were placed in a non-supine position at the second location, respectively. The authors conclude that most parents place their infants in sleep environments with established risk factors and, among infants moved during the night, many were placed in the non-supine position in the second location. Dr. Phillipi has disclosed no financial relationship relevant to this commentary. This commentary does not contain a discussion of an unapproved/investigative use of a commercial product/device. The 1992 Back to Sleep Campaign was rebooted in 2011 by the American Academy of Pediatrics with additional evidence-based recommendations to promote safe infant sleep and reduce the risk of infant sleep-related deaths.1 Some of these recommendations, like placing infants on their backs for sleep and breastfeeding, are met with universal accord, whereas others, such as pacifiers and bed-sharing, are debated. Exhausted new parents are the recipients of conflicting recommendations from their health care providers, their family and friends, the media, and retailers. Pediatricians who are clearly in a position to impart evidence-based information are opting out; 1 in 5... You do not currently have access to this content.