The Role of the Father in Child Sleep Disturbance: Child, Parent, and Parent-Child Relationship

Millikovsky-Ayalon, M., Atzaba-Poria, N. and Meiri, G. (2015), The Role of the Father in Child Sleep Disturbance: Child, Parent, and Parent-Child Relationship. Infant Mental Health J.I, 36: 114–127. doi:10.1002/imhj.21491Hpotheses:

1. In families with children who have sleep disturbances, children would have fussier temperament; mothers and fathers would express higher levels of parental stress and report having more parental bedtime interactions characterized by interference with the child's self-regulation of sleep–wake cycles; mother–child and father–child interactions during feeding would be less positive; and fathers would be less involved in child caregiving than would those in the comparison group.
2. Paternal involvement in child caregiving would act as a buffer, moderating the group differences for all study variables. Specifically, variables in the three contextual levels will be more negative in families having children with sleep disturbances only when coupled with low paternal involvement in child caregiving.

Design Cross-sectionalVariables Measured, Instruments Used

1. Child Temperament
   1. Fussy-Difficult scale of the Infant Characteristics Questionnaire -(Parental Report)
2. Parental Stress
   1. Parenting Stress Index - (Self-Report)
3. Parental Bedtime Interaction
   1. Questionnaire adjusted from the Sleep Habits Questionnaire- (Rated by mothers)
4. Parent-Child Feeding Interaction
   1. Emotional Availability Scales
5. Parental Involvement
   1. Subscale of the “Who Does What?” Scale - (Parent Interview)

Participants

• N= 51

• Participant ages: one to three-years-old (53% boys; M = 1.93, SD = .76) and their mothers (M = 31.08, SD = 4.62) and fathers (M = 33.61, SD = 5.31) participated in the study
• Location: Southern region of Israel
• Eligibility: All participating children were singletons, from two-parent, Hebrew-speaking families living in the Southern region of Israel. The sample included a majority of urban and suburban families (92%) and a minority of families living in rural (4%) and collective communities. Children with developmental delays and premature babies were excluded. Recruitment was conducted using a screening questionnaire distributed through the sleep laboratory at the local hospital, well-baby clinics, and mainstream daycare centers. Screening questionnaire was based on Richman's (1981) criteria of severe sleep problems, defined as a child who awakens three or more times per night, five to seven nights per week. The inclusion criteria included the absence of known organic causes for the sleep disturbances.
• SES: Not Provided.
• Additional profile: Children were selected for the comparison group if their parents reported that they had no night-waking disturbances during the previous 2 months. All children in the comparison group were matched to children in the sleep-disturbance group for age, gender, birth order, and maternal education

Limitations

1. From a transactional perspective, child sleep and the way it is perceived in families can be shaped by factors in multiple contexts.
2. One important factor related to parenting practices regarding child sleep is cultural differences such as family place of residence or childrearing environment. Most of the families in the current study lived in urban areas, with a minority of families living in rural and collective communities Moreover, this study was conducted in a specific culture, the Israeli culture, and thus the interpretation of the data and the generalization of the findings should be considered with caution.
3. Although research has suggested that parental report is essential when studying a child's sleep, this method is subjective and thus may be influenced by parental characteristics and by the parent–child relationship, and thus may not be accurate.
4. To reduce parental burden and increase their participation, only mothers reported on the bedtime interaction, not fathers.
5. The present study found a strong relationship between child sleep disturbances and various factors in three contextual levels: child, parent, and child–parent relationship. However, the study's ability to reach conclusions about the nature of causality is limited due to its cross-sectional design.

Finding(s)

1. The first hypothesis, regarding group differences at the different contextual levels, was partially confirmed.
   1. At the child level, differences nearing significance were found in child temperament. Children with sleep disturbances were rated as fussier than were those in the comparison group.
   2. The examination of the parental context revealed that fathers as well as mothers in the sleep-disturbance group reported having elevated levels of stress related to the parenting role than did parents in the comparison group.
   3. At the contextual level of parent–child interaction, parental bedtime interactions, including greater use of active physical comforting strategies, were found in the sleep-disturbance group than for those found in the comparison group.
   4. Examination of parental emotional availability beyond bedtime revealed that fathers in the sleep-disturbance group were less sensitive to their children during feeding interaction than were fathers in the comparison group. This supports the notion that the quality of parent–child relations, beyond bedtime interactions, can have a significant regulating function on child sleep and that parent–child transactions around bedtime and during the night develop within a wider interpersonal context, including daytime caring tasks.
   5. Parents in the comparison group responded less frequently to their children's signals of distress at night, but were more consistent and attuned to their children's needs during a daytime interaction. This supports that a parental lower level of involvement at night is a positive behavior that enhances children's ability to develop independent sleeping
2. The second hypothesis proposing a moderation effect for paternal involvement was partially confirmed.
   1. In  families having a child with sleep disturbances, mothers reported higher levels of stress than did mothers in the comparison group, but only when coupled with low paternal involvement in child caregiving.
   2. The same moderation effect, although somewhat weaker and only approaching significance, was revealed for fathers.