Effect of a behavioral-educational sleep intervention for first-time mothers and their infants: pilot of a controlled trial

Abstract

This study tested the acceptability and efficacy of a perinatally delivered behavioral-educational sleep intervention. Methods: Participants were 40 primiparous women assigned in late pregnancy to either an intervention (n = 20) or control (n = 20) group. The sleep intervention group (SIG) received prenatal anticipatory education and guidance regarding their own and their infant's sleep during the first 3 months postpartum. This was reinforced during phone calls within the first 6 weeks postpartum. The control group (CG) received brief sleep hygiene information at a prenatal session, followed by 2 phone calls during the same period. Mother-infant pairs wore actigraphs for 48 hours at 6 and 12 weeks postpartum, and mothers kept sleep diaries. Questionnaires completed in late pregnancy and 6 and 12 weeks postpartum related to sleep, newborn care, and mood. The main outcome measures included maternal sleep quantity, efficiency, and self-reported quality and infant sleep duration and consolidation. Results: Mothers reported high acceptability of the study processes. Sleep duration and quality increased for mothers and infants across time in both groups, with a significantly greater increase in nocturnal sleep duration for mothers in the SIG. Conclusions: Prenatal sleep guidance and postnatal follow-up seems to enhance nocturnal sleep of mothers, change their perceptions of their own sleep, and increase confidence in managing their infant's sleep. Follow-up at later intervals and replication with larger, more diverse samples may reveal further differences.

Infant sleep as a topic in healthcare guidance of parents, prenatally and the first 6 months after birth: a scoping review

“… 21. Sweeney et al (2020) [ 26 ] New Zealand A pilot testing of a perinatally delivered behavioral-educational sleep intervention (PIPIS). 20 mothers formed a control-group (CG) and 20 a sleep intervention-group (SIG).…”

“…Six studies, published in the last 5 years, describe infant sleep-related interventions with high relevance for the early postnatal period [ 26 – 28 , 56 , 58 , 59 ]. In addition, four reviews summarize earlier studies and discuss the degree to which sleep-related interventions may increase sleep outcomes in the postnatal period of life [ 29 , 53 – 55 ].…”

“…A review from 2013 concluded that behavioral sleep interventions during the first six months of life do not have significant effects on infant sleep [ 53 ], while later reviews reported several positive effects [ 29 , 54 , 55 ]. Some studies found that early interventions may increase infants’ night-time sleep [ 26 , 54 ], reduce the frequency of nightwakings [ 71 ], increase the use of recommended early bedtimes for infants [ 56 ], prevent prolonged bedtime routines, eat as the last activity before sleep [ 27 , 56 ], and help infants to sleep more regularly in their own cot [ 27 ]. No intervention reported effects related to the duration or frequency of infant crying.…”

“…Nevertheless, we could not identify any focus on infant safe sleep issues in the SBY program description. A recurrent theme across included studies is the importance of giving parents knowledge about newborn infants’ sleep behaviors and states, and that these patterns differ significantly from sleep in older infants and adults [ 26 , 55 , 58 , 75 ]. A similar focus is prominent in the framework of newborn behavioral observation (NBO) [ 2 , 35 ], where health practitioners are educated on how to help parents understand and adapt to their children’s sleep and other behaviors.…”

“…There seems to be a lack of studies addressing which topics of sleep advice should be addressed and when. When screening publications over the last 20 years, we detected interventions initiated during pregnancy [ 26 ], maternity wards [ 27 ], and postnatal care [ 28 , 29 ]. Research shows some inconsistencies in advice and the factors that influence parents` adherence to safe sleep guidelines, and many parents do not use safe sleep practices at home [ 30 , 31 ].…”