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Efficacy of an internet-based intervention for infant and toddler sleep disturbances
Jodi A Mindell1, Courtney E Du Mond, Avi Sadeh
1The Children’s Hospital of Philadelphia and Saint Joseph’s University, Department of Psychology, Philadelphia, PA 19131, USA. j0l@sju.edu
Insights
An internet-based intervention significantly improved infant and toddler sleep problems, including sleep onset and night wakings. This approach also enhanced maternal sleep, mood, and confidence in managing their child's sleep.
Area of Science:
- Pediatric Sleep Medicine
- Behavioral Health Interventions
- Digital Health
Background:
- Sleep disturbances affect 20-30% of young children, with many remaining untreated due to reliance on in-person professional support.
- Internet-based interventions offer a scalable solution to increase access to effective sleep treatments for infants and toddlers.
- Existing behavioral interventions, while effective, face accessibility challenges.
Purpose of the Study:
- To evaluate the efficacy of an internet-based intervention for infant and toddler sleep disturbances.
- To assess the impact of the intervention on maternal sleep, mood, and confidence.
- To determine the feasibility of a digital approach for pediatric sleep issues.
Main Methods:
- A 3-week randomized controlled trial involving 264 mothers and their children (6-36 months).
- Families were assigned to an algorithmic internet-based intervention, the same intervention with a bedtime routine, or a control group.
- Standardized questionnaires measured sleep, mood, and maternal confidence weekly.
Main Results:
- Both internet-based interventions significantly reduced problematic sleep behaviors, including sleep onset latency and night wakings (P<0.001).
- Improvements in sleep continuity and maternal confidence were observed within one week, with further benefits by week two.
- Maternal sleep quality and mood also showed significant positive changes.
Conclusions:
- Internet-based interventions are effective for improving multiple facets of infant and toddler sleep, particularly wakefulness and continuity.
- The intervention positively impacts maternal well-being, including sleep and mood.
- Digital health solutions provide a viable and accessible method for addressing pediatric sleep problems.
Objective:
Sleep problems occur in 20% to 30% of young children. Although behaviorally based interventions are highly efficacious, most existing interventions require personal contact with a trained professional, and unfortunately many children remain untreated. However, the use of an internet-based intervention could provide widespread access. Thus, the purpose of this study was to examine the efficacy of an internet-based intervention for infant and toddler sleep disturbances, as well as to assess any indirect benefits to maternal sleep, mood, and confidence.
Methods:
264 mothers and their infant or toddler (ages 6-36 months) participated in a 3-week study. Families were randomly assigned to one of 2 intervention groups (algorithmic internet-based intervention alone or in combination with a prescribed bedtime routine) or a control group. After a one-week baseline (usual routine), the intervention groups followed personalized recommendations during weeks 2 and 3. All mothers completed the Brief Infant Sleep Questionnaire, the Pittsburgh Sleep Quality Index, and the Profile of Mood States weekly.
Results:
Both internet-based interventions resulted in significant reductions in problematic sleep behaviors. Significant improvements were seen in latency to sleep onset and in number/duration of night wakings, P<0.001. Sleep continuity increased as well as mothers' confidence in managing their child's sleep. Improvements were seen by one week, with additional benefits by week two. Maternal sleep and mood were also significantly improved.
Conclusions:
This internet-based intervention (with and without routine) is beneficial in improving multiple aspects of infant and toddler sleep, especially wakefulness after sleep onset and sleep continuity, as well as improving maternal sleep and mood.
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