Parents of a new baby are often asked, “Are they a good sleeper?” Behind this lies memories of the enquirer’s own sleepless nights or the general recognition that infants are renowned for their capacity to disrupt the life of the family for at least the first three months. These questions assume that infant sleep difficulties are inside the child, but as systems thinkers we should consider the possibility that the definition of a ‘sleep problem’ may have an interactional component.
What Determines the Definition of a ‘Sleep Problem?’
The first year of life sees the establishment of the homeostatic and circadian processes that support sustained sleep, with newborns sleeping for brief episodes over a 24-hour span. The inherent unpredictability of this coupled with a barrage of on-line information and opinion about what an infant ’should’ be doing can easily undermine the most relaxed parent and lead them to question if their child has a problem. Socio-cultural factors may also determine this perception with higher rates of parental reporting of infant sleep difficulties in Asian as compared to Caucasian countries. Other variables include a parent’s sense of helplessness, an inclination to attribute distress to their child and less willingness to set limits around sleep. A parent’s capacity to tolerate crying, depression, fatigue, and daytime sleepiness are all correlated with this attribution.
How Can we Assess this Question?
Researchers Kahn et al (2025) sought to examine ‘which objective infant sleep measures and parent factors are most strongly associated with perceived infant sleep problems, and whether these associations differed by parent gender.’ Data on Infant sleep and parental crib visits was collected using auto-videosomnograph while an online survey collected data on perceived sleep problems, parent depression, daytime sleepiness, cry tolerance, and sociodemographic characteristics.
What Did They Find?
The results clearly demonstrated that the definition of a ‘sleep problem’ was shaped more by the parental emotional state than the child’s behaviour, with parental crib visits, depressive symptoms, and cry tolerance the strongest correlates of perceived difficulties. The largest single indicator of perceived sleep problems was nighttime crib visits with each additional visit increasing the possibility of this definition by 18%. Education level and current breastfeeding was also associated with higher perception of problematic sleep attesting to the importance of broader contextual and cultural elements. Gender differences were identified with infant nighttime sleep duration and parental daytime sleepiness linked to mothers’ definitions while cry tolerance was a strong correlate for fathers.
What are the Implications of these Findings?
In working with families with a child defined as having problematic sleep we need to take the broadest view that incorporates both parents and the culture and society in which they live. Supporting parents to appreciate that the problem is not ‘inside’ their little one and addressing emotional regulation, their relationship and the power of definitions beyond the immediate family unit will go a long way to improve everybody’s rest.
Kahn,M., Poches,M., Barnett,N., Gradisar,M. Does your baby have a sleep problem? Auto-videosomnography and parent-reported correlates of perceived infant sleep problems Sleep Medicine 134 (2025)
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