Parentally perceived early childhood insomnia is associated with reduced infant nocturnal sleep continuity, increased maternal daytime dysfunction, and poorer paternal sleep quality, with parental emotional adaptation and expectations shaping the perception of sleep problems.
Key Findings
Results
Infants with parentally perceived early childhood insomnia (ECI) had significantly worse sleep characteristics on parent-reported measures compared to controls.
Infants with ECI had longer sleep onset time and wakefulness after sleep onset, more frequent night awakenings, and shorter total sleep duration (p < 0.01) as measured by the Brief Infant Sleep Questionnaire (BISQ).
Sample included 41 families with ECI and 45 families without ECI, with infants aged 6–36 months.
All BISQ-based sleep differences were statistically significant at p < 0.01.
Results
Actigraphy data revealed no significant objective sleep differences between ECI and control infants, except for later bedtimes and wake times in the control group.
Objective actigraphy measurements did not corroborate most parent-reported sleep differences between groups.
The only actigraphy-detected difference was later bedtimes and wake times in the control (non-ECI) group.
This discrepancy between objective and subjective measures highlights the role of parental perception in defining infant sleep problems.
Results
Mothers in the ECI group had significantly higher depression and anxiety scores compared to mothers in the control group.
Maternal depression and anxiety scores were significantly higher in the ECI group (p < 0.01).
Fathers in the ECI group also had higher anxiety scores (p = 0.048).
Mental health was assessed in both parents as part of the family sleep health framework.
Results
After controlling for parental mental health, higher number of infant night awakenings, maternal daytime dysfunction, and paternal subjective sleep quality were independent predictors of parentally perceived ECI.
Logistic regression was used to identify predictors of parentally perceived ECI.
The three significant predictors were: infant night awakening frequency, maternal daytime dysfunction, and paternal subjective sleep quality.
These associations remained significant even after controlling for parental mental health symptoms.
The finding implicates both infant sleep behavior and distinct parental sleep health dimensions as contributing factors.
Results
Qualitative thematic analysis revealed that parental emotional adaptation and expectations shaped the perception of infant sleep problems.
In-depth interviews were conducted with parents and analyzed using thematic analysis.
Themes related to parental emotional adaptation and expectations emerged as central to how parents perceived and defined sleep problems.
This qualitative finding helps explain the discrepancy between objective actigraphy data and parent-reported sleep problems.
Methods
The study employed a mixed-method design combining quantitative sleep assessments with qualitative parental interviews within a family sleep health framework.
Infant sleep was evaluated using both the Brief Infant Sleep Questionnaire (BISQ) and actigraphy.
Parents were assessed for mental health symptoms and sleep characteristics.
In-depth interviews were conducted to explore parental perception of infant sleep.
The convenience sample included infants aged 6–36 months with and without sleep problems and their parents.
Both logistic regression (quantitative) and thematic analysis (qualitative) were applied.
What This Means
This research suggests that when parents report their young child has a sleep problem (called early childhood insomnia, or ECI), the issue extends well beyond the child's sleep itself. The study followed 86 families with infants aged 6 to 36 months and found that while parents of children with ECI reported their infants woke up more at night and slept less overall, objective sleep monitors (actigraphy) worn by the infants did not show most of these same differences. This gap between what parents reported and what the monitors measured suggests that how parents perceive and interpret their child's sleep plays a significant role in whether a sleep problem is identified.
The study also found that ECI had measurable effects on the whole family. Mothers in the ECI group had higher levels of depression and anxiety, and fathers had higher anxiety. Importantly, even after accounting for these mental health factors, a mother's daytime tiredness and a father's poor sleep quality were independently linked to parents perceiving their infant as having a sleep problem. In-depth interviews with parents further revealed that their emotional coping styles and expectations about infant sleep shaped whether they viewed the situation as problematic.
This research suggests that addressing early childhood sleep problems may need to involve the entire family rather than focusing solely on the infant. Interventions that support parental mental health, improve parental sleep, and help set realistic expectations about normal infant sleep behavior could be important components of care. The finding that objective and subjective sleep measures diverged also highlights that a parent's perception of their child's sleep is influenced by their own wellbeing and emotional state, not just by how the child actually sleeps.
Baris H, Us M, Barlak H, Boran P. (2026). Sleep health in the family Context: Predictors and qualitative exploration of parentally perceived early childhood insomnia.. Sleep medicine. https://doi.org/10.1016/j.sleep.2026.108817