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Patterns of Developmental Change in Infants’ Nighttime Sleep Awakenings from 6 through 36 Months of Age

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Sample

N: 1,200
Subject Ages: 6, 15, 24 and 36 months
Location: United States, hospitals at 10 data collection sites
SES: 24% ethnic minority, 11% of mothers did not complete high school, 14% single mothers (groups not mutually exclusive)
Eligibility: Not available
Additional: The sample was not designed to be nationally representative. However, the sample was similar to families in the census tract records and the nation as a whole on key demographic variables (household income and ethnicity).

Objectives

Estimate the developmental trajectories of children’s sleep awakenings.
Identify important variables associated with the developmental trajectories by examining relations of the trajectories with temperament, breastfeeding experiences, attachment security, health problems during infancy, and familial and environmental risk factors.
Examine individual differences in sleep awakenings at specific points across infancy.

Variables Measured, Instruments Used

Number of nights per week with sleep awakenings - standardized interview
Sleep problems - the Child Behavior Checklist (CBCL 2-3; Achenbach, 1992)
Gender and birth weight - interview
Temperament - 39 items selected from the 55 items on the Infant Temperament Questionnaire (Medoff Cooper, Carey, & McDevitt, 1993)
Whether mother breastfeeds - mother report
Attachment quality - the Strange Situation
Child illnesses - mother report
Maternal depression - the Center for Epidemiological Studies Depression Scale (CES-D; Radloff, 1977)
Maternal sensitivity - semi-structured, videotaped, coded interactions
Maternal health - mother report
Spouse/partner in the home - mother report
Poverty - mother report
Child care - mother report

Design—Correlational

Findings

The two groups of children identified in this study appear to represent meaningful and distinct longitudinal patterns with regard to the developmental course of sleep.
Not only were the patterns of sleep awakenings empirically distinctive, but membership in the groups was predictable from child and family characteristics.
On average, the children who were “becoming sleepers” (defined by more frequent night awakenings), compared with “sleepers” (defined by little evidence of elevated sleep awakenings at any point from 6 months to 3 years), were more likely to be male, be breastfed, have a more difficult temperament, come from a large family, have a depressed mother, have a mother without a spouse or partner and/or be in child care for fewer hours.
Most of these differences resolved at 18 months.

Limitations

Reliance on maternal report
Infants with many perceived awakenings may be perceived as having difficult temperaments.
Restricted sample: All infants were healthy at birth, and there were no twins, low birth-weight or premature infants.
Correlational study

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