Severe sleep problems among infants

Thunström, M. 2002. Severe Sleep Problems among Infants. A Five-Year Prospective Study. Acta Universitatis Upsaliensis. Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine 1108. 77 pp. Uppsala. ISBN 91-554-5201-9. The aim of this thesis was to explore the prevalence of parentally experienced infant sleep problems, with special interest in severe problems, in a total community sample of 2 518 infants aged between 6 and 18 months. Factors associated with severe sleep problems were sought. Parents reported 16 % of the infants to have difficulties in falling asleep at night, and 30 % to have frequent night waking. Severe sleep problems were associated with frequent night meals, psychosocial problems in the family, exhaustion and depression in the mother, and parental stress. An association with infant difficultness, high activity and problematic behaviour was also found. In a five-year prospective study a group of children fulfilling specific criteria for severe sleep problems in infancy (N=27) was followed after an interventional sleep programme and compared with a control group regarding sleep characteristics, behaviour and development. One month after an interdisciplinary treatment programme, combining behavioural technique with family work, the average number of times the case babies woke up had diminished from 6.0 to 1.8 times per night. A 92 % rate of improvement was reported. The changes were stable over time. Comparisons with the controls during five years revealed no significant group difference in sleep characteristics. Concerning behaviour and development, however, there were significant differences. At the age of 5.5 years, seven of the children in the former sleep problem group met the criteria for the diagnosis of attention-deficit/hyperactivity disorder. No control child qualified for the diagnosis. Close follow-ups of infants with combined severe sleep and behavioural problems are recommended.