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. 2001 Jan;84(1):15–19. doi: 10.1136/adc.84.1.15

Economic evaluation of strategies for managing crying and sleeping problems

S Morris 1, J St 1, J Sleep 1, P Gillham 1
PMCID: PMC1718606  PMID: 11124777

Abstract

AIMS—To estimate the financial cost to the NHS of infant crying and sleeping problems in the first 12 weeks of age and to assess the cost effectiveness of behavioural and educational interventions aimed at reducing infant crying and sleeping problems relative to usual services.
METHODS—A cost burden analysis and cost effectiveness analysis were conducted using data from the Crying Or Sleeping Infants (COSI) Study, a three armed prospective randomised controlled trial that randomly allocated 610 mothers to a behavioural intervention (n = 205), an educational intervention (n = 202), or existing services (control, n = 203). Main outcome measures were annual total cost to the NHS of infant crying and sleeping problems in the first 12 weeks, and incremental cost per interruption free night gained for behavioural and educational interventions relative to control.
RESULTS—The annual total cost to the NHS of infant crying and sleeping problems in the first 12 weeks was £65 million (US$104 million). Incremental costs per interruption free night gained for the behavioural intervention relative to control were £0.56 (US$0.92). For the educational intervention relative to control they were £4.13 (US$6.80).
CONCLUSIONS—The annual total cost to the NHS of infant crying and sleeping problems is substantial. In the cost effectiveness analysis, the behavioural intervention incurred a small additional cost and produced a small significant benefit at 11 and 12 weeks of age. The educational intervention incurred a small additional cost without producing a significant benefit.



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Selected References

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  1. Anders T. F., Keener M. A., Kraemer H. Sleep-wake state organization, neonatal assessment and development in premature infants during the first year of life. II. Sleep. 1985;8(3):193–206. doi: 10.1093/sleep/8.3.193. [DOI] [PubMed] [Google Scholar]
  2. Briggs A., Fenn P. Confidence intervals or surfaces? Uncertainty on the cost-effectiveness plane. Health Econ. 1998 Dec;7(8):723–740. doi: 10.1002/(sici)1099-1050(199812)7:8<723::aid-hec392>3.0.co;2-o. [DOI] [PubMed] [Google Scholar]
  3. Forsyth B. W., Leventhal J. M., McCarthy P. L. Mothers' perceptions of problems of feeding and crying behaviors. A prospective study. Am J Dis Child. 1985 Mar;139(3):269–272. doi: 10.1001/archpedi.1985.02140050063023. [DOI] [PubMed] [Google Scholar]
  4. Hughes D., Morris S. The cost-effectiveness of condoms in the prevention of HIV infection in England and Wales: should condoms be available on prescription? J Health Serv Res Policy. 1996 Oct;1(4):205–211. doi: 10.1177/135581969600100405. [DOI] [PubMed] [Google Scholar]
  5. Minde K., Popiel K., Leos N., Falkner S., Parker K., Handley-Derry M. The evaluation and treatment of sleep disturbances in young children. J Child Psychol Psychiatry. 1993 May;34(4):521–533. doi: 10.1111/j.1469-7610.1993.tb01033.x. [DOI] [PubMed] [Google Scholar]
  6. Pinilla T., Birch L. L. Help me make it through the night: behavioral entrainment of breast-fed infants' sleep patterns. Pediatrics. 1993 Feb;91(2):436–444. [PubMed] [Google Scholar]
  7. Scott G., Richards M. P. Night waking in infants: effects of providing advice and support for parents. J Child Psychol Psychiatry. 1990 May;31(4):551–567. doi: 10.1111/j.1469-7610.1990.tb00797.x. [DOI] [PubMed] [Google Scholar]
  8. St James-Roberts I., Halil T. Infant crying patterns in the first year: normal community and clinical findings. J Child Psychol Psychiatry. 1991 Sep;32(6):951–968. doi: 10.1111/j.1469-7610.1991.tb01922.x. [DOI] [PubMed] [Google Scholar]
  9. St James-Roberts I., Hurry J., Bowyer J. Objective confirmation of crying durations in infants referred for excessive crying. Arch Dis Child. 1993 Jan;68(1):82–84. doi: 10.1136/adc.68.1.82. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Wolke D., Gray P., Meyer R. Excessive infant crying: a controlled study of mothers helping mothers. Pediatrics. 1994 Sep;94(3):322–332. [PubMed] [Google Scholar]
  11. van Hout B. A., Al M. J., Gordon G. S., Rutten F. F. Costs, effects and C/E-ratios alongside a clinical trial. Health Econ. 1994 Sep-Oct;3(5):309–319. doi: 10.1002/hec.4730030505. [DOI] [PubMed] [Google Scholar]

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