Paul Ian M, Savage Jennifer S, Anzman-Frasca Stephanie, Marini Michele E, Mindell Jodi A, Birch Leann L
Pediatrics and Public Health Sciences, Penn State College of Medicine, Hershey, Pennsylvania;
Center for Childhood Obesity Research, Penn State College of Health and Human Development, University Park, Pennsylvania;
Pediatrics. 2016 Jul;138(1). doi: 10.1542/peds.2016-0762.
Inadequate sleep during infancy is associated with adverse outcomes for infants and families. We sought to improve sleep behaviors and duration through a responsive parenting (RP) intervention designed for obesity prevention.
The Intervention Nurses Start Infants Growing on Healthy Trajectories (INSIGHT) study is a randomized trial comparing a RP intervention with a safety control. Primiparous mother-newborn dyads were randomized after childbirth, and research nurses delivered intervention content at home visits at infant ages 3, 16, 28, and 40 weeks and at a research center visit at 1 year. The RP sleep component included developmentally appropriate messages about bedtime routines, sleep location and behaviors, and responses to wakings. Portions of the Brief Infant Sleep Questionnaire were administered 2, 8, and 52 weeks after birth with expanded sleep-related data collection at 16 and 40 weeks.
Two hundred and seventy-nine dyads completed the first home visit; 90.7% completed the 1-year visit. Compared with controls, RP group infants were less likely to have prolonged bedtime routines >45 minutes and more likely to have earlier bedtimes at 16 and 40 weeks. They were less likely to be fed immediately before bed and more likely to self-soothe to sleep. At 8, 16, and 40 weeks, RP group nocturnal sleep duration was longer by 35, 25, and 22 minutes, respectively (P < .05 for all). Sleep duration at 1 year was similar between groups.
The INSIGHT RP intervention positively influenced developmentally appropriate bedtime routines, sleep-related behaviors, and sleep duration for infants.
婴儿期睡眠不足会给婴儿及其家庭带来不良后果。我们试图通过一项为预防肥胖而设计的响应式育儿(RP)干预措施来改善睡眠行为和时长。
“干预护士启动婴儿健康成长轨迹”(INSIGHT)研究是一项随机试验,比较了RP干预措施与安全对照措施。初产妇与新生儿的二元组在分娩后被随机分组,研究护士在婴儿3周、16周、28周和40周时进行家访,并在1岁时在研究中心进行家访,提供干预内容。RP睡眠部分包括关于就寝常规、睡眠地点和行为以及对醒来反应的适合其发育阶段的信息。在出生后2周、8周和52周进行简短婴儿睡眠问卷的部分调查,并在16周和40周进行与睡眠相关的扩展数据收集。
279个二元组完成了首次家访;90.7%完成了1岁时的访视。与对照组相比,RP组婴儿在16周和40周时,就寝常规延长超过45分钟的可能性较小,上床睡觉时间较早的可能性较大。他们睡前立即被喂食的可能性较小,自我安抚入睡的可能性较大。在8周、16周和40周时,RP组夜间睡眠时间分别延长了35分钟、25分钟和22分钟(所有P值均<0.05)。两组在1岁时的睡眠时间相似。
INSIGHT RP干预措施对婴儿适合其发育阶段的就寝常规、与睡眠相关的行为和睡眠时间产生了积极影响。