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Published on: February 5, 2019
Effectiveness of an mHealth Intervention for Infant Sleep Disturbances
Erin S Leichman1, Russell A Gould2, Ariel A Williamson3
1Saint Joseph's University.
Insights
This study shows a mobile health sleep intervention improved infant sleep and caregiver behavior. The Customized Sleep Profile app led to better sleep for infants with existing sleep problems.
Area of Science:
- Pediatrics
- Behavioral Science
- Public Health
Background:
- Infant sleep problems and night wakings are common issues for caregivers.
- Existing behavioral sleep interventions often lack real-world accessibility and scalability.
Purpose of the Study:
- To evaluate the real-world effectiveness of a mobile health (mHealth) behavioral sleep intervention, the Customized Sleep Profile (CSP).
- To assess changes in infant sleep patterns and caregiver behaviors using the CSP app.
Main Methods:
- A total of 404 infants (6-11.9 months) and their caregivers used the free, publicly available CSP smartphone application.
- Caregivers completed the Brief Infant Sleep Questionnaire-Revised (BISQ-R) at baseline and follow-up (4-28 days).
- Sleep outcomes were analyzed based on infant sleep problem status (problem vs. no problem sleepers).
Main Results:
- Sleep onset latency improved for all infants; earlier bedtimes and longer sleep stretches were observed in infants with prior sleep problems.
- Infants with sleep problems showed decreased night wakings and improved caregiver-reported sleep quality and behavioral changes.
- Both groups experienced improvements in overall sleep time and bedtime routine regularity, with greater changes in the problem-sleeper group.
Conclusions:
- A publicly available mHealth behavioral sleep intervention (CSP) is effective in improving infant sleep outcomes in real-world settings.
- The intervention led to positive changes in caregiver behavior and sleep-related outcomes, even with short-term use.
- mHealth interventions offer a scalable and accessible approach to addressing common infant sleep challenges.
Abstract:
Bedtime problems and night wakings are highly prevalent in infants. This study assessed the real-world effectiveness of an mHealth behavioral sleep intervention (Customized Sleep Profile; CSP). Caregivers (83.9% mothers) of 404 infants (age 6 to 11.9 m, M = 8.32 m, 51.2% male) used the CSP (free and publicly available behavioral sleep intervention delivered via smartphone application, Johnson's® Bedtime® Baby Sleep App). Caregivers completed the Brief Infant Sleep Questionnaire-Revised (BISQ-R) at baseline and again 4 to 28 days later. Changes in sleep patterns were analyzed, based on sleep problem status (problem versus no problem sleepers; PS; NPS). Sleep onset latency improved in both groups. Earlier bedtimes, longer continuous stretches of sleep, as well as decreased number and duration of night wakings, were evident in the PS group only. The BISQ-R Total score, total nighttime sleep, and total 24-hour sleep time improved for both groups, with a greater change for the PS group. Further, caregivers of infants in the PS group decreased feeding (bedtime and overnight) and picking up overnight, and perceived better sleep. Bedtime routine regularity, bedtime difficulty, sleep onset difficulty, and caregiver confidence improved for both groups, with the PS group showing a greater magnitude of change. Thus, a real-world, publicly available, mHealth behavioral sleep intervention was associated with improved outcomes for older infants. Intervention recommendations resulted in changes in caregivers' behavior and improvements in caregiver-reported sleep outcomes in infants, in as few as 4 days.
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