Real-World Implementation of Infant Behavioral Sleep Interventions: Results of a Parental Survey
Sarah M Honaker1, Amy J Schwichtenberg2, Tamar A Kreps3
1Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN.
Insights
Most parents successfully implement behavioral sleep interventions (BSI) for infants, reducing crying within a week. This study describes parental practices and outcomes of BSI used outside clinical settings.
Area of Science:
- Pediatrics
- Sleep Medicine
- Child Psychology
Background:
- Behavioral sleep interventions (BSI) are common for infant sleep problems.
- Parental experiences implementing BSI outside clinical settings are not well-described.
Purpose of the Study:
- To describe parental practices and outcomes when implementing behavioral sleep interventions (BSI) in a non-clinical setting.
- To understand parent experiences with different BSI approaches.
Main Methods:
- An online survey was completed by 652 parents recruited from a Facebook group supporting BSI use.
- Parents reported on their experiences using BSI with infants aged 5.6 months on average.
- Data collected included BSI type, parental stress, infant crying duration, and implementation success.
Main Results:
- Most parents used modified extinction (49.5%) or unmodified extinction (34.9%).
- Parental stress and infant crying were highest on the first night but significantly reduced after one week.
- 83% reported successful BSI implementation on the first attempt, with 79% achieving success within two weeks.
Conclusions:
- The majority of parents successfully implement BSI, observing reduced infant crying and improved sleep within two weeks.
- Few differences were noted between various behavioral approaches used.
- BSI is effective when implemented by parents outside of formal clinical settings.
Objective:
To describe parental practices implementing behavioral sleep intervention (BSI) outside a clinical setting.
Study Design:
Parents (n = 652), recruited through a Facebook group designed as a peer support group for parents using BSI, completed an online survey about their experience using BSI with their infant or toddler.
Results:
On average, parents implemented BSI when their infant was 5.6 (±2.77) months. Parents most often used modified (49.5%) or unmodified extinction (34.9%), with fewer using a parental presence approach (15.6%). Regardless of BSI type, more parents endorsed "a great deal of stress" during the first night (42.2%) than 1 week later (5.2%). The duration of infant crying was typically greatest the first night (reported by 45%; M = 43 minutes) and was significantly reduced after 1 week (M = 8.54 minutes). Successful implementation of BSI on the first attempt was reported by 83%, with a median and mode of 7 days until completion (79% by 2 weeks). Regardless of BSI type, after intervention parents reported their infant had less difficulty falling asleep, fewer night awakenings, and were more likely to sleep in their room and/or in their own crib/bed.
Conclusions:
The majority of parents report successfully implementing BSI, with significantly reduced infant crying by the end of 1 week and success within 2 weeks. Few differences were found between behavioral approaches.
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