Yale School of Nursing, West Haven, Connecticut.
Yale Child Study Center, Yale University School of Nursing, West Haven, Connecticut.
Res Nurs Health. 2020 Aug;43(4):329-340. doi: 10.1002/nur.22023. Epub 2020 Apr 19.
Racially and ethnically diverse young children who live with socioeconomic adversity are at high risk for sleep deficiency, but few behavioral sleep interventions (BSIs) are tailored to their needs. To support the future development of a feasible, acceptable, and culturally relevant sleep intervention, we conducted a community-engaged, mixed-methods study with 40 low-income, racially, and ethnically diverse parents to describe sleep characteristics, sleep habits, and parental sleep knowledge of their 6-36-month-old children and to examine the associations between children's sleep characteristics and sleep habits. This report presents quantitative data from this mixed-methods study. We measured objective (actigraphy) and parent-reported sleep (Brief Infant Sleep Questionnaire) characteristics, sleep habits at bedtime, sleep onset, and during night awakenings, parental sleep knowledge, psychological function (Brief Symptom Inventory), and parenting stress (Parenting Stress Index). Children had low sleep duration (537.2 ± 54.7 nighttime and 111.2 ± 29.8 nap minutes), late bedtimes (22:36 ± 1.5 hr), and high bedtime variability (mean squared successive difference = 3.68 ± 4.31 hr) based on actigraphy. Parental knowledge about sleep recommendations was limited. Sleep habits before bedtime, at sleep onset, and during night awakenings were varied. Sixty-five percent of parents reported co-sleeping. Feeding near bedtime or during the night was associated with later bedtimes, more fragmented sleep, and increased bedtime variability. These findings suggest the need for BSIs to support earlier bedtimes and improve sleep duration and continuity by addressing modifiable behaviors. Tailored BSIs that consider socioecological influences on the development of sleep habits are needed.
生活在社会经济逆境中的不同种族和族裔的幼儿面临着睡眠不足的高风险，但很少有行为睡眠干预 (BSI) 针对他们的需求。为了支持未来开发可行、可接受和具有文化相关性的睡眠干预措施，我们对 40 名低收入、不同种族和族裔的父母进行了一项社区参与的混合方法研究，以描述他们 6-36 个月大的孩子的睡眠特征、睡眠习惯和父母的睡眠知识，并研究孩子的睡眠特征与睡眠习惯之间的关联。本报告介绍了这项混合方法研究的定量数据。我们测量了客观（活动记录仪）和家长报告的睡眠（婴儿睡眠简短问卷）特征、睡前、入睡和夜间觉醒时的睡眠习惯、父母的睡眠知识、心理功能（简明症状量表）和育儿压力（父母压力指数）。根据活动记录仪的数据，儿童的睡眠时间较短（夜间 537.2±54.7 分钟，小睡 111.2±29.8 分钟），就寝时间较晚（22:36±1.5 小时），就寝时间变化较大（均方连续差异=3.68±4.31 小时）。父母对睡眠建议的了解有限。睡前、入睡时和夜间觉醒时的睡眠习惯各不相同。65%的父母报告说会与孩子同睡。睡前或夜间喂奶与就寝时间较晚、睡眠碎片化程度较高和就寝时间变化较大有关。这些发现表明，需要行为睡眠干预来支持更早的就寝时间，并通过解决可改变的行为来提高睡眠持续时间和连续性。需要量身定制的行为睡眠干预措施，考虑到睡眠习惯发展的社会生态影响。
