How Do Mothers Help Their Children Sleep at Night? Night-waking Strategy Use Among Mothers of Preschool-aged Children

Coulombe J. A., and Reid G. J. (2014), How Do Mothers Help Their Children Sleep at Night? Night-waking Strategy Use Among Mothers of Preschool-aged Children, Inf. Child. Dev., 23, pages 494–517. doi: 10.1002/icd.1844Objective:To present preliminary evidence for the reliability and validity of the Night-waking Strategies Scale (NSS) and explore night-waking strategy use.Hypotheses:

1. NSS punishment would be positively correlated with over-reactive parenting.
2. NSS routines would be negatively correlated with parenting laxness (permissiveness and inconsistency).
3. There is increasing evidence for some consistency between children’s general and night-time behaviors; as such, it is expected that a degree of continuity between general and night-time parenting should also exist.
4. Agreement with a night-waking strategy would be correlated with use of that strategy.
5. Consistency between parents’ settling strategies at bedtime and the strategies that they employ during night-waking. Parents’ bedtime settling strategies are believed to set the conditions for children’s ability to settle back to sleep independently following a night-time awakening          

Design: scale developmentVariables Measured, Instruments Used:

1. Night-Waking Strategies Scale (Self-Report)
2. Measures of general parenting, night-waking beliefs, and night-waking
3. Parenting Scale (PS) - (Self-Report )
4. Night-Waking Vignettes Scale (NVS) - (Self-Report)
5. Modified Infant Sleep Questionnaire (ISQ) - (Self-Report)

Participants

• N= 203
• Participant ages: Mothers (Mage=32.4years) of preschool-aged children (Mage = 3.4 years)
• Location: London, Ontario area, community sample.
• Eligibility: Criteria included having a generally healthy two to five-year-old child who had woken up during the night at least once every 2 weeks during the month prior to study enrolment. Inclusion criteria were not restricted to only those children who would meet the diagnostic criteria or research guidelines for disordered sleep.
• SES: Less than 10% (n = 17) reported a total family income of less than $20 000 (Canadian); approximately 35% (n=71) reported a total family income between $20000 and $59 999; another 30% (n = 64) reported a total family income between $60 000 and $99 999; and 18% (n = 36) reported a total family income of $100 000 or greater.
• Additional profile: Most mothers were Caucasian (90%, n = 182); 11 parents (5%) did not report on this variable. The remaining 5% of parents endorsed a variety of backgrounds. Approximately 15% (n = 30) reported having a high school education or less, and most had completed a college/trade diploma or university degree (69%, n = 141); 11% had completed a professional, masters, or doctoral degree.

Limitations:

1. Relatively broad inclusion criteria. Did not require the presence of clinically significant night-waking for participation.
2. Sample was composed entirely of mothers, most of whom were Caucasian, educated, and believed that children should sleep independently. The extent to which results may generalize to other populations is unknown.
3. Compared children grouped by age. Dividing sample into these age groupings did lower the power to detect other potentially meaningful differences within these age groupings, and they did not examine differences between children ages four and five years old. Subsequent research with larger sample sizes is needed.                    
4. Insufficient variability in validation sample to properly examine the influence of mothers’ demographic background on the factor structure of the NSS or on NSS subscale scores. Shared method variance likely accounts for some of the associations in the present study.
5. All measures were mothers’ self-report.

Finding(s)

1. NSS punishment was positively correlated with overreactivity; however, this was only true for mothers of older children (four to five-year-olds).
2. NSS punishment was also positively correlated with laxness; again, this association was significant for older children only.
3. NSS routines were negatively correlated with laxness across age groups.
4. Mothers’ self-reported strategy use was positively correlated with their agreement with that strategy (e.g., active comforting was positively correlated with agreement with active comforting). This hypothesis was supported across ages, with the exception of agreement with punishment for mothers of younger children and agreement with limit-setting for mothers of older children.
5. NSS limit-setting was negatively correlated with agreement with active comforting.        
6. Across ages, active comforting at bedtime was positively correlated with active comforting through the night. The strength of this correlation appeared to decrease with age.
7. Active comforting was positively correlated with the frequency of night-waking for two and three-year-olds, the frequency of co-sleeping across ages, and mothers of three-year-olds’ perception of their child’s sleep as problematic.
8. NSS rewards was positively correlated with the frequency of night- waking, the frequency of co-sleeping, and mothers’ perceptions of their child’s sleep as problematic, but only for the middle-age group.
9. Routines were negatively correlated with mothers of 2-year-olds’ perceptions of their child’s sleep as problematic, while punishment was positively correlated with the frequency of night- waking among 3-year-olds.