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A Cluster Analysis of Reported Sleeping Patterns of 9-Month Old Infants and the Association with Maternal Health: Results from a Population Based Cohort Study

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Abstract

The aim of this study was to identify, using cluster analysis, novel sleep phenotypes in a population based cohort of infants, and to explore the associations between infant sleep profiles and their mothers’ health and well-being. 11,134 mothers of 9-month old infants were interviewed as part of the Growing Up in Ireland National Longitudinal study and reported on their health and infant’s sleep patterns. 16 infant sleep variables were recorded together with measures of parental stress, depression, health and well-being. Multiple iterations of a two-step hierarchical cluster analysis were carried out to identify the optimum number of clusters and the subset of parental-reported sleep variables required to identify distinct sleep profiles. Four distinct sleep profiles were identified based on the following variables; (1) infant sleep duration at night, (2) parental sleep duration, (3) does baby wake during night (yes, no)? (4) Usual sleep location for most of the night and, (5) parental reporting of problem infant sleep patterns. This identified two less favorable profiles with both infants and mothers sleeping less and where mothers are more likely to report their infants’ sleep patterns as problematic. Mothers of infants belonging to these sleep profiles were more likely to have higher levels of stress, depressive symptoms, and poorer self-reported health than other sleep profiles. Breastfeeding was associated with both groups and rates were highest in a group of infants that were more likely to co-sleep with their parents and have diverse ethnic backgrounds. This study demonstrates, for the first time, two infant sleep profiles with distinct phenotypical frameworks that are significantly associated with maternal stress, depression, and poorer self-report of health.

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References

  1. Mindell, J. A., Meltzer, L. J., Carskadon, M. A., & Chervin, R. D. (2009). Developmental aspects of sleep hygiene: Findings from the 2004 National Sleep Foundation Sleep in America Poll. Sleep Medicine, 10(7), 771–779.

    Article  PubMed  Google Scholar 

  2. Byars, K. C., Yeomans-Maldonado, G., & Noll, J. G. (2011). Parental functioning and pediatric sleep disturbance: An examination of factors associated with parenting stress in children clinically referred for evaluation of insomnia. Sleep Medicine, 12(9), 898–905.

    Article  PubMed  Google Scholar 

  3. Meijer, A. M., & van den Wittenboer, G. L. (2007). Contribution of infants’ sleep and crying to marital relationship of first-time parent couples in the 1st year after childbirth. Journal of Family Psychology, 21(1), 49–57.

    Article  PubMed  Google Scholar 

  4. Touchette, E., Petit, D., Séguin, J. R., Boivin, M., Tremblay, R. E., & Montplaisir, J. Y. (2007). Associations between sleep duration patterns and behavioral/cognitive functioning at school entry. Sleep, 30(9), 1213–1219.

    PubMed Central  PubMed  Google Scholar 

  5. Meltzer, L. J., & Mindell, J. A. (2007). Relationship between child sleep disturbances and maternal sleep, mood, and parenting stress: A pilot study. Journal of Family Psychology, 21(1), 67–73.

    Article  PubMed  Google Scholar 

  6. Golik, T., Avni, H., Nehama, H., Greenfeld, M., Sivan, Y., & Tauman, R. (2013). Maternal cognitions and depression in childhood behavioral insomnia and feeding disturbances. Sleep Medicine, 14(3), 261–265.

    Article  PubMed  Google Scholar 

  7. Hiscock, H., & Wake, M. (2001). Infant sleep problems and postnatal depression: A community-based study. Pediatrics, 107(6), 1317–1322.

    Article  CAS  PubMed  Google Scholar 

  8. Lam, P., Hiscock, H., & Wake, M. (2003). Outcomes of infant sleep problems: A longitudinal study of sleep, behavior, and maternal well-being. Pediatrics, 111(3), e203–e207.

    Article  PubMed  Google Scholar 

  9. Armitage, R., Flynn, H., Hoffmann, R., Vazquez, D., Lopez, J., & Marcus, S. (2009). Early developmental changes in sleep in infants: The impact of maternal depression. Sleep, 32(5), 693–696.

    PubMed Central  PubMed  Google Scholar 

  10. McLearn, K. T., Minkovitz, C. S., Strobino, D. M., Marks, E., & Hou, W. (2006). Maternal depressive symptoms at 2 to 4 months post partum and early parenting practices. Archives of Pediatrics and Adolescent Medicine, 160(3), 279–284.

    Article  PubMed  Google Scholar 

  11. Gruber, R., Laviolette, R., Deluca, P., Monson, E., Cornish, K., & Carrier, J. (2010). Short sleep duration is associated with poor performance on IQ measures in healthy school-age children. Sleep Medicine, 11(3), 289–294.

    Article  PubMed  Google Scholar 

  12. Carvalho Bos, S., Gomes, A., Clemente, V., Marques, M., Pereira, A. T., Maia, B., et al. (2009). Sleep and behavioral/emotional problems in children: A population-based study. Sleep Medicine, 10(1), 66–74.

    Article  CAS  PubMed  Google Scholar 

  13. Biggs, S. N., Lushington, K., van den Heuvel, C. J., Martin, A. J., & Kennedy, J. D. (2011). Inconsistent sleep schedules and daytime behavioral difficulties in school-aged children. Sleep Medicine, 12(8), 780–786.

    Article  PubMed  Google Scholar 

  14. France, K. G., & Blampied, N. M. (1999). Infant sleep disturbance: Description of a problem behaviour process. Sleep Medicine Reviews, 3(4), 265–280.

    Article  Google Scholar 

  15. Palmstierna, P., Sepa, A., & Ludvigsson, J. (2008). Parent perceptions of child sleep: A study of 10,000 Swedish children. Acta Paediatrica, 97(12), 1631–1639.

    Article  PubMed  Google Scholar 

  16. Mindell, J. A., Sadeh, A., Kohyama, J., & How, T. H. (2010). Parental behaviors and sleep outcomes in infants and toddlers: A cross-cultural comparison. Sleep Medicine, 11(4), 393–399.

    Article  PubMed  Google Scholar 

  17. Nevarez, M. D., Rifas-Shiman, S. L., Kleinman, K. P., Gillman, M. W., & Taveras, E. M. (2010). Associations of early life risk factors with infant sleep duration. Academic Pediatrics, 10(3), 187–193.

    Article  PubMed Central  PubMed  Google Scholar 

  18. Mindell, J. A., Sadeh, A., Wiegand, B., How, T. H., & Goh, D. Y. (2010). Cross-cultural differences in infant and toddler sleep. Sleep Medicine, 11(3), 274–280.

    Article  PubMed  Google Scholar 

  19. Loutzenhiser, L., Ahlquist, A., & Hoffman, J. (2011). Infant and maternal factors associated with maternal perceptions of infant sleep problems. Journal of Reproductive and Infant Psychology, 29(5), 460–471.

    Article  Google Scholar 

  20. Middlemiss, W. (2004). Infant sleep: A review of normative and problematic sleep and interventions. Early Child Development and Care, 174(1), 99–122.

    Article  Google Scholar 

  21. Galland, B. C., Taylor, B. J., Elder, D. E., & Herbison, P. (2012). Normal sleep patterns in infants and children: A systematic review of observational studies. Sleep Medicine Reviews, 16(3), 213–222.

    Article  PubMed  Google Scholar 

  22. Thorpy, M. J. (2012). Classification of sleep disorders. Neurotherapeutics, 9(4), 687–701.

    Article  PubMed Central  PubMed  Google Scholar 

  23. Freeman, K., & Bonuck, K. (2012). Snoring, mouth-breathing, and apnea trajectories in a population-based cohort followed from infancy to 81 months: A cluster analysis. International Journal of Pediatric Otorhinolaryngology, 76(1), 122–130.

    Article  PubMed  Google Scholar 

  24. Joosten, S. A., Hamza, K., Sands, S., Turton, A., Berger, P., & Hamilton, G. (2012). Phenotypes of patients with mild to moderate obstructive sleep apnoea as confirmed by cluster analysis. Respirology, 17(1), 99–107.

    Article  PubMed  Google Scholar 

  25. Williams, J., Greene, S., McNally, S., Murray, A., & Quail, A. (2010). The infants and their families. Infant Cohort. Report 1. Dublin: Department of Minister for Health and Children.

    Google Scholar 

  26. Quail, A., Williams, J., & McCrory, C. (2011). Sample design and response in wave 1 of the infant cohort (at 9 months) of Growing Up in Ireland. Dublin: Department of Health and Children.

    Google Scholar 

  27. Berry, J. O., & Jones, W. H. (1995). The Parental Stress Scale: Initial psychometric evidence. Journal of Social and Personal Relationships, 12(3), 463–472.

    Article  Google Scholar 

  28. Radloff, L. (1977). The CES-D Scale: A self report depression scale for research in the general population. Applied Psychological Measurement, 1, 385–401.

    Article  Google Scholar 

  29. DeLeon, C. W., & Karraker, K. H. (2007). Intrinsic and extrinsic factors associated with night waking in 9-month-old infants. Infant Behavior and Development, 30(4), 596–605.

    Article  PubMed  Google Scholar 

  30. Byars, K. C., Yolton, K., Rausch, J., Lanphear, B., & Beebe, D. W. (2012). Prevalence, patterns, and persistence of sleep problems in the first 3 years of life. Pediatrics, 129(2), e276–e284.

    Article  PubMed Central  PubMed  Google Scholar 

  31. Kendall-Tackett, K. (2007). A new paradigm for depression in new mothers: The central role of inflammation and how breastfeeding and anti-inflammatory treatments protect maternal mental health. International Breastfeeding Journal, 2, 6.

    Article  PubMed Central  PubMed  Google Scholar 

  32. Karraker, K. H., & Young, M. (2007). Night waking in 6-month-old infants and maternal depressive symptoms. Journal of Applied Developmental Psychology, 28(5–6), 493–498.

    Article  PubMed Central  PubMed  Google Scholar 

  33. Warren, S. L., Howe, G., Simmens, S. J., & Dahl, R. E. (2006). Maternal depressive symptoms and child sleep: Models of mutual influence over time. Development and Psychopathology, 18(1), 1–16.

    Article  PubMed  Google Scholar 

  34. Dørheim, S. K., Bondevik, G. T., Eberhard-Gran, M., & Bjorvatn, B. (2009). Sleep and depression in postpartum women: A population-based study. Sleep, 32(7), 847–855.

    PubMed Central  PubMed  Google Scholar 

  35. Sadeh, A., Mindell, J., & Rivera, L. (2011). “My child has a sleep problem”: A cross-cultural comparison of parental definitions. Sleep Medicine, 12(5), 478–482.

    Article  PubMed  Google Scholar 

  36. Bayer, J. K., Hiscock, H., Hampton, A., & Wake, M. (2007). Sleep problems in young infants and maternal mental and physical health. Journal of Paediatrics and Child Health, 43(1–2), 66–73.

    Article  PubMed  Google Scholar 

  37. Goldberg, W. A., Lucas-Thompson, R. G., Germo, G. R., Keller, M. A., Davis, E. P., & Sandman, C. A. (2013). Eye of the beholder? Maternal mental health and the quality of infant sleep. Social Science and Medicine, 79, 101–108.

    Article  PubMed Central  PubMed  Google Scholar 

  38. Cortesi, F., Giannotti, F., Sebastiani, T., Vagnoni, C., & Marioni, P. (2008). Cosleeping versus solitary sleeping in children with bedtime problems: Child emotional problems and parental distress. Behavioral Sleep Medicine, 6(2), 89–105.

    Article  PubMed  Google Scholar 

  39. Sinai, D., & Tikotzky, L. (2012). Infant sleep, parental sleep and parenting stress in families of mothers on maternity leave and in families of working mothers. Infant Behavior and Development, 35(2), 179–186.

    Article  PubMed  Google Scholar 

  40. McKenna, J., & McDade, T. (2005). Why babies should never sleep alone: A review of the co-sleeping controversy in relation to SIDS, bedsharing and breast feeding. Paediatric Respiratory Reviews, 6, 134–152.

    Article  PubMed  Google Scholar 

  41. Hiscock, H., Bayer, J., Gold, L., Hampton, A., Ukoumunne, O. C., & Wake, M. (2007). Improving infant sleep and maternal mental health: A cluster randomised trial. Archives of Disease in Childhood, 92(11), 952–958.

    Article  PubMed Central  PubMed  Google Scholar 

  42. Hiscock, H., Bayer, J. K., Hampton, A., Ukoumunne, O. C., & Wake, M. (2008). Long-term mother and child mental health effects of a population-based infant sleep intervention: Cluster-randomized, controlled trial. Pediatrics, 122(3), e621–e627.

    Article  PubMed  Google Scholar 

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Author information

Authors and Affiliations

  1. University Hospital Limerick, Dooradoyle, Limerick, Ireland

    Aoife Hughes

  2. Graduate Entry Medical School, University of Limerick, Limerick, Ireland

    Aoife Hughes & Ailish Hannigan

  3. Department of Psychology, Centre for Social Issues Research, University of Limerick, Limerick, Ireland

    Stephen Gallagher

Authors
  1. Aoife Hughes
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  2. Stephen Gallagher
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  3. Ailish Hannigan
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Correspondence to Aoife Hughes.

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Hughes, A., Gallagher, S. & Hannigan, A. A Cluster Analysis of Reported Sleeping Patterns of 9-Month Old Infants and the Association with Maternal Health: Results from a Population Based Cohort Study. Matern Child Health J 19, 1881–1889 (2015). https://doi.org/10.1007/s10995-015-1701-6

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  • DOI: https://doi.org/10.1007/s10995-015-1701-6

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