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Cosleeping and sleep problems in children: a systematic review and meta-analysis

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Abstract

There exist inconsistent findings about the relation between cosleeping and sleep problems in children. We conducted a meta-analysis to assess these relations and compared their cross-cultural differences. We searched the EMBASE, PsycARTICLES, PsycINFO, PubMed, ScienceDirect, and Web of Science databases. A random effect model was used, and subgroup analysis by culture group was performed. By including fifteen qualified studies, this meta-analysis revealed that increased bedtime resistance, sleep anxiety, night waking, and parasomnia were shown from children cosleeping with others. Cosleeping children from the West performed more bedtime resistance and night waking, while those children from the East showed more parasomnia. In general, cosleeping is associated with several sleep disturbances for children, including bedtime resistance, sleep anxiety, night waking, and parasomnia, and the cultural differences do exist between the West and East. The findings provide initial evidence of the influence of cosleeping on children’s sleep problems. More studies on the related topic are needed from diverse cultures in the future.

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References

  1. Liu X, Liu L, Wang R. Bed sharing, sleep habits, and sleep problems among Chinese school-aged children. Sleep. 2003;26:839–44.

    PubMed  Google Scholar 

  2. Stores G. Children’ s sleep disorders: modern approaches, developmental effects, and children at special risk. Dev Med Child Neurol. 1999;41:568–73.

    CAS  PubMed  Google Scholar 

  3. Cappuccio FP, Taggart FM, Kandala NB, Currie A, Peile E, Stranges S, et al. Meta-analysis of short sleep duration and obesity in children and adults. Sleep. 2008;31:619–26.

    PubMed  PubMed Central  Google Scholar 

  4. Dev DA, Mcbride BA, Fiese BH, Jones BL, Cho H. Risk factors for overweight/obesity in preschool children: an ecological approach. Child Obes. 2013;9:399–408.

    PubMed  PubMed Central  Google Scholar 

  5. Miller MA, Kruisbrink M, Wallace J, Ji C, Cappuccio FP. Sleep duration and incidence of obesity in infants, children, and adolescents: a systematic review and meta-analysis of prospective studies. Sleep. 2018. https://doi.org/10.1093/sleep/zsy018.

    Article  PubMed  Google Scholar 

  6. Adams HL, Matson JL, Cervantes PE, Goldin RL. The relationship between autism symptom severity and sleep problems: should bidirectionality be considered? Res Autism Spectr Disord. 2014;8:193–9.

    Google Scholar 

  7. Gregory AM, Sadeh A. Sleep, emotional and behavioral difficulties in children and adolescents. Sleep Med Rev. 2012;16:129–36.

    PubMed  Google Scholar 

  8. Amintehran E, Ghalehbaghi B, Asghari A, Jalilolghadr S, Ahmadvand A, Foroughi F. High prevalence of sleep problems in school-and preschool-aged children in Tehran: a population based study. Iranian J Pediatr. 2013;23:45–52.

    Google Scholar 

  9. El-Sheikh M, Bagley EJ, Keiley M, Elmore-Staton L, Chen E, Buckhalt JA. Economic adversity and children’ s sleep problems: multiple indicators and moderation of effects. Health Psychol. 2013;32:849–59.

    PubMed  Google Scholar 

  10. Olds T, Blunden S, Petkov J, Forchino F. The relationships between sex, age, geography and time in bed in adolescents: a meta-analysis of data from 23 countries. Sleep Med Rev. 2010;14:371–8.

    PubMed  Google Scholar 

  11. Owens JA. Sleep in children: cross-cultural perspectives. Sleep Biol Rhythm. 2004;2:165–73.

    Google Scholar 

  12. Owens JA, Jones C, Nash R. Caregivers’ knowledge, behavior, and attitudes regarding healthy sleep in young children. J Clin Sleep Med. 2011;7:345–50.

    PubMed  PubMed Central  Google Scholar 

  13. Wang G, Xu G, Liu Z, Lu N, Ma R, Zhang E. Sleep patterns and sleep disturbances among Chinese school-aged children: prevalence and associated factors. Sleep Med. 2013;14:45–52.

    PubMed  Google Scholar 

  14. Owens JA. Introduction: culture and sleep in children. Pediatrics. 2005. https://doi.org/10.1542/peds.2004-0815a.

    Article  PubMed  Google Scholar 

  15. Liu Z, Wang G, Geng L, Luo J, Li N, Owens JA. Sleep patterns, sleep disturbances, and associated factors among Chinese urban kindergarten children. Behav Sleep Med. 2016;14:100–17.

    PubMed  Google Scholar 

  16. Jiang Y, Chen W, Spruyt K, Sun W, Wang Y, Li S, et al. Bed-sharing and related factors in early adolescents. Sleep Med. 2016;17:75–80.

    PubMed  Google Scholar 

  17. Cortesi F, Giannotti F, Sebastiani T, Vagnoni C. Cosleeping and sleep behavior in Italian school-aged children. J Dev Behav Pediatr. 2004;25:28–33.

    PubMed  Google Scholar 

  18. Cortesi F, Giannotti F, Sebastiani T, Vagnoni C, Marioni P. Cosleeping versus solitary sleeping in children with bedtime problems: child emotional problems and parental distress. Behav Sleep Med. 2008;6:89–105.

    PubMed  Google Scholar 

  19. Jenni OG, Fuhrer HZ, Iglowstein I, Molinari L, Largo RH. A longitudinal study of bed sharing and sleep problems among Swiss children in the first 10 years of life. Pediatrics. 2005;1:1. https://doi.org/10.1542/peds.2004-0815e.

    Article  Google Scholar 

  20. Lozoff B, Askew GL, Wolf AW. Cosleeping and early childhood sleep problems: effects of ethnicity and socio-economic status. J Dev Behav Pediatr. 1996;17:9–15.

    CAS  PubMed  Google Scholar 

  21. Lozoff B, Wolf AW, Davis NS. Cosleeping in urban families with young children in the United States. Pediatrics. 1984;74:171–82.

    CAS  PubMed  Google Scholar 

  22. Rath FH, Okum ME. Parents and children sleeping together: cosleeping prevalence and concerns. Am J Orthopsychiatr. 1995;65:411–8.

    Google Scholar 

  23. Schatcher FF, Fuchs ML, Bijur PE, Stone RK. Cosleeping and sleep problems in Hispanic-American urban young children. Pediatrics. 1989;84:522–30.

    Google Scholar 

  24. Welles-Nystrom B. Co-sleeping as a window into Swedish culture: considerations of gender and health care. Scand J Caring Sci. 2005;19:354–60.

    PubMed  Google Scholar 

  25. Yang CK, Hahn HM. Cosleeping in young Korean children. J Dev Behav Pediatr. 2002;23:151–7.

    PubMed  Google Scholar 

  26. Conover Hanks C, Gould Rebelsky F. Mommy and the midnight visitor: a study of occasional co-sleeping. Psychiatry. 1977;40:277–80.

    PubMed  Google Scholar 

  27. Latz S, Wolf AW, Lozoff B. Cosleeping in context: sleep practices and problems in young children in Japan and the United States. Arch Pediatr Adolesc Med. 1999;153:339–46.

    CAS  PubMed  Google Scholar 

  28. Archbold KH, Pituch KJ, Panahi P, Chervin RD. Symptoms of sleep disturbances among children at two general pediatric clinics. J Pediatr. 2002;140:97–102.

    PubMed  Google Scholar 

  29. Fricke-Oerkermann L, Plück J, Schredl M, Heinz K, Mitschke A, Wiater A, et al. Prevalence and course of sleep problems in childhood. Sleep. 2007;30:1371–7.

    PubMed  PubMed Central  Google Scholar 

  30. Hiscock H, Canterford L, Ukoumunne OC, Wake M. Adverse associations of sleep problems in Australian preschoolers: national population study. Pediatrics. 2007;119:86–93.

    PubMed  Google Scholar 

  31. Liu X, Liu L, Owens JA, Kaplan DL. Sleep patterns and sleep problems among schoolchildren in the United States and China. Pediatrics. 2005. https://doi.org/10.1542/peds.2004-0815f.

    Article  PubMed  Google Scholar 

  32. Meltzer LJ, Mindell JA. Behavioral sleep disorders in children and adolescents. Psychiatr Clin North Amer. 2006;29:1059–76.

    Google Scholar 

  33. Mindell JA, Kuhn B, Lewin DS, Meltzer LJ, Sadeh A. Behavioral treatment of bedtime problems and night wakings in infants and young children. Sleep. 2006;29:1263–76.

    PubMed  Google Scholar 

  34. Owens JA. Sleep disorders and attention-deficit/hyperactivity disorder. Curr Psychiatry Rep. 2008;10:439–44.

    PubMed  Google Scholar 

  35. Paavonen EJ, Aronen ET, Moilanen I, Piha J, Räsänen E, Tamminen T, et al. Sleep problems of school-aged children: a complementary view. Acta Paediatr. 2000;89:223–8.

    CAS  PubMed  Google Scholar 

  36. Shang CY, Gau SSF, Soong WT. Association between childhood sleep problems and perinatal factors, parental mental distress and behavioral problems. J Sleep Res. 2006;15:63–73.

    PubMed  Google Scholar 

  37. Spruyt K, O’brien LM, Cluydts R, Verleye GB, Ferri R. Odds, prevalence and predictors of sleep problems in school age normal children. J Sleep Res. 2005;14:163–76.

    PubMed  Google Scholar 

  38. Owens JA. Cosleeping. J Dev Behav Pediatr. 2002;23:254–5.

    PubMed  Google Scholar 

  39. Weimer SM, Dise TL, Evers PB, Ortiz MA, Welidaregay W, Steinmann WC. Prevalence, predictors, and attitudes toward cosleeping in an urban pediatric center. Clin Pediatr. 2002;41:433–8.

    Google Scholar 

  40. Kim E, Lee R, Cain KC. Cosleeping, sleep disturbances, children’ s behavioral problems, and parenting self-efficacy among Korean American families. J Child Adolesc Psychiatr Nurs. 2017;30:112–20.

    PubMed  Google Scholar 

  41. Owens JA, Spirito A, Mcguinn M. The children’ s Sleep Habits Questionnaire (CSHQ): psychometric properties of a survey instrument for school-aged children. Sleep. 2000;23:1043–51.

    CAS  PubMed  Google Scholar 

  42. Barajas RG, Martin A, Brooks-Gunn J, Hale L. Mother-child bed-sharing in toddlerhood and cognitive and behavioral outcomes. Pediatrics. 2011;128:e339–47.

    PubMed  PubMed Central  Google Scholar 

  43. Adiga D, Gupta A, Khanna M, Taly AB, Thennarasu K. Sleep disorders in children with cerebral palsy and its correlation with sleep disturbance in primary caregivers and other associated factors. Ann Indian Acad Neurol. 2014;17:473–6.

    PubMed  PubMed Central  Google Scholar 

  44. Liu X, Hubbard JA, Fabes RA, Adam JB. Sleep disturbances and correlates of children with autism spectrum disorders. Child Psychiat Hum Dev. 2006;37:179–91.

    Google Scholar 

  45. Fukumizu M, Kaga M, Kohyama J, Hayes MJ. Sleep-related nighttime crying (Yonaki) in Japan: a community-based study. Pediatrics. 2005;115:217–24.

    PubMed  Google Scholar 

  46. Mindell JA, Sadeh A, Kohyama J, How TH. Parental behaviors and sleep outcomes in infants and toddlers: a cross-cultural comparison. Sleep Med. 2010;11:393–9.

    PubMed  Google Scholar 

  47. Downs SH, Black N. The feasibility of creating a checklist for the assessment of the methodological quality both of randomised and non-randomised studies of health care interventions. J Epidemiol Community Health. 1998;52:377–84.

    CAS  PubMed  PubMed Central  Google Scholar 

  48. Deeks JJ, Altman DG, Bradburn MJ. Statistical methods for examining heterogeneity and combining results from several studies in meta-analysis. In: Egger M, Smith GD, Altman DG, editors. Systematic reviews in health care: meta-analysis in context. 2nd ed. London: BMJ Publishing Group; 2001. p. 285–312.

    Google Scholar 

  49. Higgins J, Thompson SG, Deeks JJ, Altman DG. Measuring inconsistency in meta-analyses. BMJ. 2003;327:557–60.

    PubMed  PubMed Central  Google Scholar 

  50. Egger M, Smith GD, Schneider M, Minder C. Bias in meta-analysis detected by a simple, graphical test. BMJ. 1997;315:629–34.

    CAS  PubMed  PubMed Central  Google Scholar 

  51. Kelmanson IA. Sleep disturbances in two-month-old infants sharing the bed with parent(s). Minerva Pediat. 2010;62:161–9.

    CAS  PubMed  Google Scholar 

  52. Mindell JA, Leichman ES, Walters RM. Sleep location and parent-perceived sleep outcomes in older infants. Sleep Med. 2017;39:1–7.

    PubMed  Google Scholar 

  53. Iwata S, Iwata O, Matsuishi T. Sleep patterns of japanese preschool children and their parents: implications for co-sleeping. Acta Paediatr. 2013;102:e257–62.

    PubMed  PubMed Central  Google Scholar 

  54. Baddock SA, Galland BC, Bolton DPG, Williams SM, Taylor BJ. Differences in infant and parent behaviors during routine bed sharing compared with cot sleeping in the home setting. Pediatrics. 2006;117:1599–607.

    PubMed  Google Scholar 

  55. Bahammam A, Alameri H, Hersi A. Cosleeping and its correlates in saudi school-aged children. Int J Behav Med. 2008;15:336–40.

    PubMed  Google Scholar 

  56. Li S, Jin X, Yan C, Wu S, Jiang F, Shen X. Bed- and room-sharing in Chinese school-aged children: prevalence and association with sleep behaviors. Sleep Med. 2008;9:555–63.

    PubMed  Google Scholar 

  57. Yu XT, Sadeh A, Lam HS, Mindell JA, Li AM. Parental behaviors and sleep/wake patterns of infants and toddlers in Hong Kong, China. World J Pediatr. 2017;13:496–502.

    PubMed  Google Scholar 

  58. Mao A, Burnham MM, Goodlin-Jones BL, Gaylor EE, Anders TF. A comparison of the sleep–wake patterns of cosleeping and solitary-sleeping infants. Child Psychiat Hum Dev. 2004;35:95–105.

    Google Scholar 

  59. Mileva-Seitz VR, Luijk MPCM, Van Ijzendoorn MH, Bakermans-Kranenburg MJ, Jaddoe VWV, Hofman A, et al. Association between infant nighttime-sleep location and attachment security: no easy verdict. Infant Ment Health J. 2016;37:5–16.

    PubMed  Google Scholar 

  60. Santos IS, Mota DM, Matijasevich A. Epidemiology of co-sleeping and nighttime waking at 12 months in a birth cohort. J Pediatr. 2008;84:114–22.

    Google Scholar 

  61. Huang XN, Wang HS, Chang JJ, Wang LH, An L. Feeding methods, sleep arrangement, and infant sleep patterns: a chinese population-based study. World J Pediatr. 2015;12:66–75.

    CAS  PubMed  Google Scholar 

  62. Hunsley M, Thoman EB. The sleep of co-sleeping infants when they are not co-sleeping: evidence that co-sleeping is stressful. Dev Psychobiol. 2002;40:14–22.

    PubMed  Google Scholar 

  63. Okami P, Weisner T, Olmstead R. Outcome correlates of parent-child bedsharing: an eighteen-year longitudinal study. J Dev Behav Pediatr. 2002;23:244–53.

    PubMed  Google Scholar 

  64. Teti DM, Shimizu M, Crosby B, Kim BR. Sleep arrangements, parent-infant sleep during the first year, and family functioning. Dev Psychol. 2016;52:1169–81.

    PubMed  PubMed Central  Google Scholar 

  65. Volkovich E, Ben-Zion H, Karny D, Meiri G, Tikotzky L. Sleep patterns of co-sleeping and solitary sleeping infants and mothers: a longitudinal study. Sleep Med. 2015;16:1305–12.

    PubMed  Google Scholar 

  66. Wang HB, Sekine M, Chen XL, Yamagami T, Kagamimori S. Lifestyle at 3 years of age and quality of life (QOL) in first-year junior high school students in Japan: results of the Toyama Birth Cohort Study. Qual Life Res. 2008;17:257–65.

    PubMed  Google Scholar 

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Acknowledgements

The authors thank Dr. Xianchen Liu for providing the original data from his publication, which allows us having more data to conduct this meta-analysis.

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  1. Center for Sleep Research, School of Psychology, Center for Studies of Psychological Application, Guangdong Key Laboratory of Mental Health & Cognitive Science, South China Normal University, Guangzhou, 510631, China

    Xiaojing Peng, Gangxuan Yuan & Ning Ma

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  1. Xiaojing Peng
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  2. Gangxuan Yuan
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Correspondence to Ning Ma.

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Peng, X., Yuan, G. & Ma, N. Cosleeping and sleep problems in children: a systematic review and meta-analysis. Sleep Biol. Rhythms 17, 367–378 (2019). https://doi.org/10.1007/s41105-019-00226-z

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