From the Journals

Behavioral sleep intervention linked to sleep improvement in infants


 

FROM THE JOURNAL OF PEDIATRICS

Infants show significant improvements in their sleep when their parents successfully carry out a behavioral sleep intervention (BSI) in a real-world setting, Sarah M. Honaker, PhD, of Indiana University, Indianapolis, and her associates, reported in the Journal of Pediatrics.

In a study of 652 parents who participated, parents started BSI when their infants were as young as less than 1 month of age and as late as 18 months of age. Most parents started BSI at 3-5 months.

A newborn sleeping in a crib. NataliaDeriabina/Getty Images
Unmodified extinction was when a parent left the room and did not return to check on the infant. Modified extinction was when a parent left the room but returned periodically to check or reassure the infant. Parental presence was when a parent stayed in the room all the time but did not interact with the baby, and parental presence with support was when the parent stayed in the room all the time and patted or picked up the infant until the baby was asleep.

Crying generally was greatest the first night, occurring in 45% of cases when all BSI approaches were considered. It lasted a mean 43 minutes, which dropped significantly after 1 week to a mean 9 minutes (P less than .001). Crying was considered most intense (on a 1-5 scale) on the initial night of BSI, a mean 4.42, and this “was equally true for all of the BSI approaches,” Dr. Honaker and her colleagues wrote.

In most cases, the parents’ first attempt at BSI worked (83%). Success varied by BSI approach, with the highest first attempt success rate in the unmodified extinction group (90%), followed by parental presence without support (83%), modified extinction (81%), and parental presence with support (65%). Eventually, 27% of parents were successful with a different approach than the one with which they started. Most commonly, they changed from modified extinction to unmodified extinction (66% of those who changed approaches).

“The majority of parents report successfully implementing BSI at a variety of ages across infancy, primarily using extinction-based approaches,” the researchers concluded. “Few significant differences were found between approaches, suggesting that health providers should offer parents options for BSI implementation.”

SOURCE: Honaker SM et al., J Pediatr. 2018. doi: 10.1016/j.jpeds.2018.04.009.

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