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Assessing infant sleep quality and arousals: comparison of wearable data with parent perspectives
Sofie de Sena1,2, Manu Airaksinen3,4, Saeed Montazeri4
1BABA Center, Paediatric Research Center, Department of Clinical Neurophysiology, Children's Hospital, Helsinki University Hospital and University of Helsinki, Helsinki, Finland. sofie.desena@helsinki.fi.
Insights
Objective infant sleep monitoring using the NAPping PAnts (NAPPA) wearable reveals significant discrepancies compared to parental reports. This technology offers a scalable solution for accurate infant sleep assessments.
Area of Science:
- Pediatrics
- Sleep Medicine
- Biomedical Engineering
Background:
- Infant sleep is crucial for development.
- Current infant sleep assessments rely on subjective parental reports.
- Objective, reliable methods for infant sleep assessment are needed.
Purpose of the Study:
- To compare parental reports of infant sleep with objective measurements.
- To evaluate the feasibility of the novel NAPping PAnts (NAPPA) wearable for at-home infant sleep monitoring.
- To assess the accuracy of parental perception of infant sleep quality and arousals.
Main Methods:
- 104 infants (424 nights) were monitored at home using the NAPPA wearable.
- Infant arousals were detected using various duration criteria.
- Parental sleep diaries captured perceived sleep quality and reported arousals.
- Correlations and regression models analyzed relationships between reported and measured sleep data.
Main Results:
- Perceived sleep quality moderately correlated with both reported and measured arousals.
- Parental reports of arousals were most comparable to NAPPA measurements of 3-5 minute durations.
- Parents underestimated short arousals and overestimated long arousals, particularly when co-sleeping.
Conclusions:
- Direct infant sleep measurements via the NAPPA wearable show significant differences from parental reports.
- Objective infant sleep monitoring is essential and now feasible with at-home wearables.
- This novel methodology opens new avenues for infant sleep research and interventions.
Background:
Infant sleep is vital for development, yet current assessments rely on subjective parental reports, underscoring the need for more reliable, objective methods.
Methods:
A total of 104 infants (424 nights) were measured at home using a novel NAPping PAnts (NAPPA) wearable, with arousals detected across a wide range of duration criteria. Parental sleep diaries were collected to capture perceived sleep quality (pSQ), reported arousals, and whether the infant slept in a shared or separate room. Diary data were used to study correlations with NAPPA-measured infant arousals, and regression models assessed the relationship between pSQ and reported versus measured arousals.
Results:
The pSQ correlated moderately with both the reported (ρ = -0.47, p < 0.001) and NAPPA-measured (ρ = -0.40, p < 0.001) arousals. The number of reported arousals was most comparable with the NAPPA-measured arousals in the 3-5-min duration range. However, parents significantly underestimated shorter arousals and overestimated longer ones, especially in a shared room with parents.
Conclusion:
Direct infant measurements with the NAPPA wearable revealed a substantial difference between directly measured and parentally reported arousals. The findings suggest that infant sleep studies should incorporate direct and objective infant measurements, now made feasible and scalable through novel at-home wearable methods.
Impact:
Infant sleep assessments typically rely on parent's subjective reports rather than objective measurements of the infant's sleep. This study addresses a critical gap by comparing parental reports of infant sleep with high-resolution, objective measurements from the novel NAPPA (NAPping PAnts) wearable, demonstrating its feasibility for at-home use. Specifically, we show that parentally reported nighttime events, such as sleep quality or infant arousals, only partially reflect the infant's actual sleeping behaviour. Our findings highlight the importance of measuring infant sleep objectively, and the novel methodology opens new research avenues that may guide sleep health interventions.
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