Effect of a consultation teaching behaviour modification on sleep performance in infants: a randomised controlled trial
Brian G Symon, John E Marley, A James Martin and Emily R Norman
MJA 2005; 182 (5):215-218
Up to 46% of parents report infant sleep problems.1-5 These include not sleeping through the night, delay in achieving sleep, and atypical behaviour at wakening. These sleep disturbances may have serious negative consequences, including postnatal depression, family breakdown and child abuse.3,6,7Disturbances may be long-lasting, with one study finding that, based on parental reports, 41% of children with sleeping disturbance at 8 months still had difficulties at 3 years.7
Studies of sleep achievement show that all individuals, including babies, “learn” to fall asleep with certain external environmental cues.1,8,9 Sleep initiation is repeated several times during the night, as all individuals repeatedly awaken for brief periods. However, these awakenings and returns to sleep are usually not understood by parents. It has been suggested that parents can inadvertently contribute to unwelcome night crying when they rock, hold, pat or feed their infant to sleep. The child may learn to re-initiate sleep repeatedly by signalling (crying) for the parent to repeat similar behaviours.10
Techniques of resolving sleep problems in infants and young children that have shown the best and most persistent results involve behaviour modification.4,11,12 Given the widespread nature of the problem and the potential for serious consequences, preventing sleep problems may be a superior strategy. Behavioural interventions have a well reported efficacy in decreasing sleep disturbance from the time of birth.5,11-13 Given the frequency of these problems and their impact upon family life, a simple intervention available from primary care services would be of value.
This study evaluated the impact of a single consultation with a trained registered nurse recommending proven behaviour-modification approaches in improving sleep in newborns.