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Children's sleep disturbances associated with parenting behaviors
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CHICAGO—Parental behaviors at bedtime when a child is age 29 to 41 months appear to be associated with sleep disturbances both earlier in childhood and later on in preschool years, according to a report in the April issue of Archives of Pediatrics & Adolescent Medicine, a theme issue on children and sleep.

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"Except for cosleeping [when parents and infants share a bed], few studies have investigated parental sleep practices and their consequences for children's sleep," the authors write as background information in the article.

Valérie Simard, M.Sc., M.Ps., of the Hôpital du Sacré-Coeur de Montréal and Université de Montréal, and colleagues administered questionnaires to 987 parents of children who were 5 months old at the beginning of the study. Each year until the children reached age 6 years, mothers or fathers answered questions about their child's sleeping habits and disturbances (such as bad dreams, short total sleep time and delays in falling asleep), psychological characteristics and sociodemographic factors.

Parents also reported their behavior at children's bedtime (including whether they lulled children to sleep, laid them down awake or stayed with them until they fell asleep) and during nighttime awakenings (including comforting children in bed, taking them out of bed, giving them food or bringing them to the parental bed for cosleeping).

"Early (age 5 to 17 months) sleep disturbances predicted maladaptive parenting behaviors (e.g., mother present at sleep onset, giving food/drink after child awakens) at ages 29 and 41 months," the authors write. "Some parental behaviors in turn predicted future bad dreams, total sleep time of less than 10 hours per night and sleep-onset latency [delays in falling asleep] of 15 minutes or more. However, most relationships did not remain significant in adjusted models that controlled for early sleep problems." Cosleeping after nighttime awakening remained associated with more than 15-minute delays in returning to sleep, while the mother's presence at the beginning of sleep appeared protective against such delays.

The results support the notion that some parental behaviors develop in response to early sleep problems, the authors note. However, they also indicate that such parental behaviors could have negative effects. "Parental strategies that were effective for early sleep difficulties (e.g. giving food or drink) may later become inappropriate to the child's age and needs. Mothers might adopt the inappropriate response of giving food or drink to 29- to 41-month-old children awakening (which is associated with bad dreams and shorter total sleep time at age 50 months) because they commonly attribute infant cries to hunger and come to believe that infants cry only when hungry," the authors write.

"Our findings clarify the long-debated relationship between parental behaviors and childhood sleep disturbances," the authors conclude. "They suggest that cosleeping and other uncommon parental behaviors have negative consequences for future sleep and are thus maladaptive."
(Arch Pediatr Adolesc Med. 2008;162[4]:360-367.

Editor's Note: Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

For more information, contact JAMA/Archives media relations at 312/464-JAMA (5262) or e-mail mediarelations{at} .

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