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. Author manuscript; available in PMC: 2021 Apr 1.
Published in final edited form as: J Fam Psychol. 2019 Nov 14;34(3):291–300. doi: 10.1037/fam0000608

Maternal Sleep Patterns and Parenting Quality during Infants’ First 6 Months

Liu Bai 1, Corey J Whitesell 1, Douglas M Teti 1
PMCID: PMC7102929  NIHMSID: NIHMS1064308  PMID: 31724407

Abstract

The present study examined both between- and within-person effects of maternal sleep patterns on quality of mothering at bedtime during infants’ first 6 months. Participants included 142 mothers who reported on their daily fall asleep and wake times across seven consecutive days with a daily sleep diary when infants were 1, 3, and 6 months old. At each age point, maternal emotional availability during one night of infant bedtime was observed and scored by trained observers who were blind to maternal sleep patterns. Multilevel modeling revealed that mothers with irregular sleep patterns, especially later average fall asleep times and greater average variability in sleep period across three age points, showed poorer parenting quality with infants at bedtime than other mothers. In addition, both between- and within-person effects of maternal sleep on bedtime parenting quality changed with infant age. Compared to mothers’ individual averages across 1, 3, and 6 months, maternal short average sleep period, increased variability in sleep period, and later fall asleep times predicted poorer bedtime parenting quality at 6 months, but not at 1 or 3 months. Results emphasize the importance of maternal sleep regulation and sleep hygiene for maternal parenting quality, especially as infants get older.

Keywords: parenting quality, parent sleep, infancy, emotional availability, bedtime

Introduction

Linkages between sleep dysregulation and problems in daily functioning are well established. Poor sleep is predictive of compromised daytime functioning in a variety of domains, including elevated depression (Riemann, Berger, & Voderholzer, 2001), cognitive dysfunction (Banks & Dinges, 2007), poor emotion regulation abilities and high negative mood (Gruber & Cassoff, 2014). In addition, marital disagreements and discord were more likely in marital couples on a day following a night of poor sleep, compared to following a night of good sleep (Maranges & McNulty, 2017), suggesting that family functioning is negatively impacted when family members’ sleep quality is inadequate.

In light of the ubiquitous impact of sleep deficiencies on cognitive, emotional and family functioning, it is of interest that very few studies have examined linkages between parental sleep and quality of parenting, and to date no study has examined sleep-parenting linkages during the early post-partum period. We believe such examination is overdue, particularly during the early post-partum, a time when sleep deficiencies among parents, particularly mothers, are common (Teti, Shimizu, Crosby, & Kim, 2016). Indeed, the attentional deficits and negative mood that result from chronic sleep deficiencies would be expected to undermine parents’ ability to provide sensitive, appropriately responsive parenting with infants (e.g., McElwain & Volling, 1999; Sethna, Murray, Netsi, Psychogiou, & Ramchandani, 2015). The present study thus examined linkages between maternal sleep patterns and quality of mothering with infants at bedtime during infants’ first 6 months of life.

A hallmark feature of competent parenting in infancy is parental sensitivity, described by Ainsworth and colleagues (Ainsworth, Blehar, Waters, & Wall, 1978) to be composed of four inter-linked components: Awareness of infant cues, accurate interpretation of cues, contingent responsiveness, and appropriate responsiveness. Insensitive parenting results from failure to meet any one or more of these criteria, which if chronic may lead to problems in the parent-child relationship and, in turn, child maladjustment (Sroufe, 2005). Parental sensitivity has many determinants (Teti & Candelaria, 2002), but one potentially important factor is adequacy of parent sleep. Daily fatigue and lack of energy that result from chronic, irregular sleep patterns may reduce parents’ capacity to monitor their children, enforce family rules, and discipline effectively (Tu, Elmore-Staton, Buckhalt, & El-Sheikh, 2018). Sleep dysregulated parents may be less aware of their children’s cues because of attentional impairments (Banks & Dinges, 2007). In addition, to the extent that dysregulated sleep leads to dysphoria and negative mood, sleep-deprived parents may be more likely than well-rested parents to misinterpret child cues that they do notice, or perhaps attend selectively to negative cues over positive cues (Walker, 2009). On this note, individuals experiencing sleep loss are more likely to report higher levels of general distress (Babson, Trainor, Feldner, & Blumenthal, 2010) and greater difficulties in controlling their negative emotions (Kahn, Sheppes, & Sadeh, 2013). Collectively, this work suggests that parents with irregular sleep patterns and insufficient sleep are at risk for engaging with their children more negatively, placing the parent-child relationship and children’s developmental trajectories at risk.

Importantly, only three published studies to date have demonstrated an association between parental sleep and parenting outcomes. Two of these focused on linkages between parenting style among parents with adolescents (Brand, Gerber, Hatzinger, Beck, & Holsboer-Trachsler, 2009; Tu et al., 2018), and both relied on adolescent-reported assessments of parenting. Brand and colleagues (2009) found that maternal but not paternal poor sleep was associated with poor parenting styles (low levels of support/commendation and high levels of reproach, restriction, and inconsistency), as rated by adolescents, which in turn negatively impacted the psychological functioning and sleep of adolescents. In line with these findings, Tu et al. (2018) found that longer maternal sleep duration and shorter maternal sleep latency assessed by actigraphy were related to fewer instances of permissive parenting by mothers. Another recent study (McQuillan, Bates, Staples, & Deater-Deckard, 2019) examined relations between actigraphic measures of maternal sleep and parenting in mothers of toddlers. Consistent with Brand et al. (2009) and Tu et al (2018), McQuillan et al. (2019) found that poorer maternal sleep (e.g., more frequent night waking, more nighttime activity, and longer latency to sleep) was associated with less positive, more dysfunctional parenting.

These studies supported the hypothesis that parenting quality could be influenced by parental sleep. Little is known, however, about linkages between parental sleep patterns and parenting quality of infants early in life. An examination of sleep and parenting during the transition to parenthood is especially important because of the dramatic changes in parental sleep patterns that take place during this time. Gay, Lee, and Lee (2004), for example, found increased sleep fragmentation for both parents and less sleep duration for mothers during the postpartum period, compared with sleep during pregnancy. Indeed, being a parent of young children has been associated with significantly shorter parental sleep duration (Hagen, Mirer, Palta, & Peppard, 2013), with much of the sleep loss among first-time mothers relating to infant care activities during the night (Insana, Garfield, & Montgomery-Downs, 2014). In sum, previous studies indicated that parents, in particular parents with young children, are at high risk for poor sleep compared to adults with no children, with sleep loss in mothers of infants associated with caregiving activities directed to the infants at night.

Both Tu et al. (2018) and Brand et al. (2009) relied on adolescent-reported questionnaires to assess parenting quality. Although parent- or child-reported parenting questionnaires are useful for assessing parenting, they are likely to be influenced by systematic personal biases, such as the reporters’ expectations and mood (Gardner, 2000; Prescott et al., 2000). Compared to self-reported measurements, parenting assessed from observational techniques is considered a stronger and more compelling predictor of child outcomes (e.g., Zaslow et al., 2006). Previous longitudinal research has demonstrated that observed parenting quality of mothers contributes to child development, including infant attachment security (Kim, Chow, Bray, & Teti, 2017), child sleep regulation (Jian & Teti, 2016), and infant stress reactivity (Philbrook et al., 2014).

In addition, the cross-sectional designs of the three published studies examining relations between parental sleep and parenting (Brand et al., 2009; Tu et al., 2018; McQuillan et al., 2019) made it difficult to make causal inferences, and in addition only enabled an assessment of between-person links. No information could be provided on whether maternal sleep and parenting quality vary together within one individual across time. Longitudinal design offers the opportunity to examine both between-person differences and within-person change in associations between maternal sleep and parenting quality simultaneously (Hoffman & Stawski, 2009). This is an important advantage over cross-sectional approaches because individual sleep across time is not uniform; variation in sleep parameters across time within the same individual is normative and expected (Knutson, Rathouz, Yan, Liu, & Lauderdale, 2007). Therefore, exploring sleep-parenting relations over time enables both between- as well as within-person assessments of sleep-parenting linkages. In the present study, we made use of direct observations of maternal parenting quality in naturalistic contexts (i.e., infant bedtimes) when infants were 1, 3 and 6 months old, and examined maternal sleep-parenting linkages as they existed between individuals as well as sleep-parenting linkages as they unfolded over time. Stated differently, our longitudinal design enabled an assessment of not only whether interindividual differences in maternal sleep could explain interindividual differences in maternal parenting quality, but also whether differences in sleep within mothers over time could be meaningfully linked to differences in maternal parenting quality over time.

Thus, the primary goal of the present study was to investigate associations between maternal sleep patterns and quality of maternal behavior at infant bedtime during infants’ first 6 months. This study contributed to the literature in several ways: (a) it is, to our knowledge, the first study to examine both between- and within-person effects of maternal sleep patterns on quality of mothering during the early post-partum period; (b) in addition to assessing between- and within-person links between maternal sleep and parenting, this study examined whether these linkages changed as infants matured (i.e., whether sleep-parenting linkages were moderated by infant age); (c) it relied on direct observations and assessments of parenting, rather than on parent report; (d) it made use of daily diary assessments of parent sleep, rather than single-point-in-time assessments, which enabled a determination of both averaged sleep across time as well as variability in maternal sleep across multiple consecutive days; (e) it used multiple indicators of maternal sleep, including fall asleep times along with mean and variability of sleep period (which is highly correlated with sleep duration; see Measures), to understand more fully how particular characteristics of maternal sleep related to parenting quality.

The present study addressed the following research questions:

  1. Does maternal sleep predict bedtime parenting quality? It is hypothesized that problematic maternal sleep (i.e., shorter sleep period and later fall asleep time) and irregular maternal sleep patterns (i.e., greater variability in sleep period) predict poorer maternal bedtime parenting quality. This hypothesis was examined in terms of both between-person differences and within-person variation in the linkages between maternal sleep and parenting quality.

  2. Do associations between maternal sleep and bedtime parenting quality change with infants age? Due to the paucity of longitudinal research in this area, directional hypotheses related to change with age were withheld.

Method

Participants

Data were drawn from Project SIESTA II, an NIH-funded longitudinal study focusing on parenting, sleep, and infant development (R01HD052809), awarded to the third author. All procedures of the study were approved by the Pennsylvania State University’s institutional review board. Eight hundred and ninety-eight families were approached at local hospitals 24–48 hours after infant birth. Due to privacy considerations, the nursing stations did not provide information on ineligible families for us to contact. Therefore, the number of eligible families was also 898, which was equal to the number of families approached. Among them, 167 families with full-term infants (46.7% males) consented to participate. Informed consent was provided and demographics were assessed at the first home visit when infants were 1 month old (Mage = 1.21, SD = 0.16). Subsequent visits in the current study were made when infants were 3 months (Mage = 3.10, SD = 0.31) and 6 months (Mage = 6.14, SD = 0.41). Twenty-five families were excluded from analyses because they failed to report socioeconomic risk or infant sleep arrangements at all time points, which resulted in a final sample of 142 mothers with infants (49.3% males). The excluded families did not differ from the subsample in the present study on study variables and socio-demographics at each time point with only one exception: mothers in the final sample were more likely to be living with their partner at 1 month (99.3% vs. 72.0%, χ2[1] = 34.73, p < .001, 3 months (98.5% vs. 70.0%, χ2[1] = 28.94, p < .001) and 6 months (96.9% vs. 68.2%, χ2[1] = 23.36, p < .001).

In the final sample, mothers ranged in age from 19 to 43 years (Mage = 29.68, SD = 5.16) and 35.9% of infants in the families were first born. The majority of mothers were married and living with their partner (85%). The proportion of single-parent household (15%) was lower than that of the two counties where the sample was gathered (i.e., 16% in Centre County, PA, and 40% in Dauphin County, PA; U.S. Census Bureau, 2017b). Seventy-two percent of mothers had completed college education, and 63% were employed at infant’s 1 month. Median yearly family income at infant’s 1 month was $65,000, which was a little higher than that of the community ($55,895 in Centre County, and $61,622 in Dauphin County; U.S. Census Bureau, 2017a). Eighty-two percent of mothers were white, 4% were Asian-American, 3% were African-American, 6% were Latino, and 5% identified themselves as “Other”, which were comparable with the ethnic proportion of the community (U.S. Census Bureau, 2017c).

Overall Procedure

Families in the larger study were home visited at 1, 3, 6, 9, 12, 18 and 24 months of infant age. The present study focused on the first three age points, a period of rapid consolidation of sleep in infancy (Teti et al., 2016). At each age point, parents completed questionnaires that collected information on socio-demographics, infant sleep arrangements, and maternal depressive symptoms. Mothers also reported on their sleep across seven consecutive days with a daily sleep diary. In addition, bedtime parenting videos were taken within each family’s home during one evening of data collection at each age point.

Measures

Socio-demographics and socioeconomic risk.

At each age point, parents reported socio-demographic characteristics, including child age, child gender, parental race, age, educational level, employment, partner status (live-in vs. no live-in partner), whether mothers were breastfeeding their infant, yearly family income, number of children and adults living in the home.

Socioeconomic risk was examined as a potential covariate as it has been linked to lower parenting quality (e.g., Chaudhuri, Easterbrooks, & Davis, 2009). In the present study, we considered socioeconomic risk to be reflected by parental age (younger = higher risk), education level (lower = higher risk), and yearly family income (lower = higher risk), based on earlier work documenting linkages between these individual risk factors and parenting quality (e.g., Camberis, McMahon, Gibson, & Boivin, 2016; Fox, Platz, & Bentley, 1995). A socioeconomic risk score was calculated by combining the reversed z score of maternal and paternal age, educational level and yearly family income at 1 month, with higher scores indicating higher levels of socioeconomic risk in the family.

Parenting quality at bedtime.

At each age point, maternal emotional availability (EA) during one night of infant bedtime was observed and scored using the Emotional Availability Scales (EAS; Biringen, 2000) as the indicator of parenting quality. Video and audio recording equipment made by Bosch Divar XF 8-Channel Digital Versatile Recorder was set up in the room where the infant slept, and where the infant was taken for any part of bedtime. The recording system included infrared security cameras made by ARM Electronics (Model No. C420BCVFIR) for video information, and Channel Vision microphones (Model No. 5104-MIC) for audio information. At least one camera was placed above the infant’s sleep location (e.g., crib or bed). Up to three additional cameras were set up to capture the chair where the infant was fed, the infant’s changing table, or an overview of the infant’s room, depending on the locations where the infant’s bedtime and nighttime took place. In order to capture all of the bedtime and nighttime routine, parents were asked to turn on the cameras 1 hour before infant’s bedtime began and turn off the system after the infant woke up in the morning. The average length of bedtime observation was 77.6 mins (ranged from 8.4 – 256.3 mins) at 1 month, 69.6 mins (ranged from 1.2 – 319.8 mins) at 3 months, and 47.1 mins (ranged from 2.5 – 246.3 mins) at 6 months. The percentage of 30-second intervals, in which mothers presented on camera with their infants at bedtime, was utilized with the length of bedtime observation to calculate the length of mother-infant interaction. The average length of mother-infant bedtime interaction providing EA scores was 53.0 mins (ranged from 0.50 – 139.91 mins) at 1 month, 46.51 mins (ranged from 0.21 – 246.34 mins) at 3 months, and 25.6 mins (ranged from 4.93–70.82 mins) at 6 months1.

Two coders who were certified and blind to maternal sleep pattern coded maternal EA using four subscales, including sensitivity, structuring, nonintrusiveness and nonhostility. Both coders participated in an EA workshop, completed the reliability cases for the EA Scales, and achieved an acceptable level of reliability with the expert coders from the developer’s laboratory. The EA coding system exhibits good construct validity with even one-time sample (e.g., Biringen, 2000; Moehler, Biringen, & Poustka, 2007) and has been adapted to the bedtime context according to criteria established in Teti, Kim, Mayer, and Countermine (2010). A single score for each subscale was provided by the coders after observing the bedtime interactions. Although some fathers were also captured on camera during infant bedtimes (approximately 25% of the full sample), coders were trained to score EA in a dyadic relationship (caregiver and child), regardless of whether other family members were present. High sensitivity was scored when mothers were observed to be sensitive to infant cues and signals, and interpreted and responded to these cues accurately. High structuring was rated when mothers could provide an adequate scaffold for interactions and set appropriate limits and boundaries in readying the infant for bed. Mother received a high score on nonintrusiveness when she followed the infant’s lead and did not infringe on the infant’s autonomy. Mother received a high score on nonhostility when she interacted with infant without expressions of overt or covert anger or irritability.

At each time point, a composite maternal EA score for each mother was created by summing the standardized z scores of the four EA subscales. The internal reliability of the maternal EA composite was adequate (αs = .81, .77 and .78 at 1, 3, and 6 months, respectively). The interrater reliability (intraclass correlations for absolute agreement) for the maternal EA composites was satisfactory based on 10% of the sample (αs =.98, .98 and .99 at 1, 3, and 6 months, respectively), indicating that coders were highly reliable in their scoring.

Maternal sleep patterns.

Mothers reported their daily sleep patterns across seven consecutive days at 1, 3, and 6 months from 24-hr Sleep Patterns Interview (24-HSPI; Meltzer, Mindell, & Levandoski, 2007), a daily sleep diary assessing subjective sleep continuity and quality. Adequate reliability and validity of the measurement have been established (Meltzer et al., 2007). In the current study, the single items assessing bedtime (i.e., “What time did you try to fall asleep last night?”) and sleep onset latency (i.e., “How long did it take you to fall asleep last night?”) were used to calculate maternal fall asleep time on each night by adding the sleep onset latency to the bedtime reported by mothers. One additional single item assessing wake time (i.e., “What time did you wake up this morning?”) was utilized with fall asleep time to calculate maternal nightly sleep period (i.e., the elapsed time from fall asleep time to wake time on each night). The compliance with mothers completing these single items was high. The percentage of mothers who provided information on all single items on at least one day was 100% at 1 month, 94.4% at 3 months and 93.0% at 6 months. The percentage of mothers providing completed sleep information on seven days was 85.2%, 76.1% and 74.6% at 1, 3 and 6 months, respectively.

Mothers’ fall asleep time (the average of the times when mothers fell asleep across the seven days), maternal sleep period (the average of the elapsed times from fall asleep time to wake time across the seven days) and variability in sleep period (the standard deviation of the sleep period across the seven days) were derived at each time point as indicators of maternal sleep patterns in the current study. Although the sleep period used in the current study was not able to account for the night wakings due to the lack of accurate self-reported information on the duration of each night waking on each night, the high correlations between the sleep period and sleep duration from actigraphy which accounted for night wakings (rs = .75, .69, & .64 at 1, 3 and 6 months, respectively with ps < .001), suggested that self-reported sleep periods are reliable indicators of the length of nighttime sleep.

Maternal depressive symptoms.

At each time point, maternal depressive symptoms were assessed via the depression subscale of Symptom Checklist-90-Revised (SCL-90-R; Derogatis, 1994), a self-reported measurement evaluating individuals’ current psychiatric symptoms. The depression subscale (e.g., “worrying too much about things”) has 13 items rated on a 0–4 point Likert scale (0 = not at all, 4 = extremely). The depressive symptoms score is the sum of these 13 items, with higher scores representative of higher levels of depression. The scale showed good reliability and validity (Derogatis, 1994) and the internal reliability of depression subscale was adequate at all time points in the present study (αs = .91, .90 and .88 at 1, 3, and 6 months, respectively). In the current sample, the proportion of mothers meeting the clinical cutoff score of 13 on depressive symptoms (Derogatis, 1994) was 18.3%, 15.5% and 11.3% at 1, 3 and 6 months, respectively. Maternal depression was considered as a potential covariate because previous research demonstrated links between depressive symptoms and parenting quality including EA (e.g., Vliegen, Luyten, & Biringen, 2009).

Infant sleep arrangements.

Mothers reported their infants’ sleep arrangements utilizing one item (“Where does your baby usually sleep at night?”) from the Sleep Practices Questionnaire (SPQ; Goldberg & Keller, 2007). At each time point, four infant sleep arrangement categories were scored based on mothers’ response: solitary sleep (infant slept in a separate room from parents), room sharing (infant slept in the same room as parents, but not in same bed), bed sharing (infant slept in the same bed as parents), and combination (infant’s sleep arrangement varied across the night). Infant sleep arrangements were then coded into three dummy variables with the solitary sleep category as the reference category. Infant sleep arrangements were tested as potential covariates based on prior work relating patterns of infant sleep arrangements to maternal EA (Teti et al., 2016).

Analytic Plan

In preliminary analyses, the descriptive statistics and bivariate correlations were calculated for study variables to test the stability of each variable across infant age and whether there were significant correlations between maternal bedtime EA and sleep patterns. At each time point, group differences based on potential covariates (i.e., maternal age, race, child gender, maternal depressive symptoms, socioeconomic risk, and infant sleep arrangements) were also examined via SPSS 21.0 to determine whether these covariates were needed to be included in primary analyses. Only the covariates which were at least marginally significantly related to the outcome (i.e., bedtime EA) at any time point (p < .10) were included in models to partial out the effects of these confounding variables.

We conducted our primary analyses using multilevel modeling (MLM) with PROC MIXED program in SAS 9.4 due to the nested nature of our data (i.e., repeated measures within subject). These analyses were conducted using Maximum Likelihood (ML) estimation2 which allows for imbalance in the structure and accommodates missing outcomes when the data are missing at random (Little’s MCAR test for our final sample was not significant, suggesting our data are likely completely missing at random, χ2[264] = 288.78, p = .141).

Because both between-person differences and within-person variations exist in the time-varying predictors, we separated the within- and between-person effects of maternal sleep patterns on bedtime EA following the recommendation of previous literature by person-mean centering the sleep variables (e.g., Enders and Tofighi, 2007; Hoffman & Stawski, 2009). The basic equations for our main model are as below.

Level 1:

Bedtime EAti = β0i + β1i(Infant ageti)+ β2i(Maternal deviations in sleep patternti) +β3i(Infant ageti× Maternal deviations in sleep patternti) + β4i-6i(Infant sleep arrangementsti) + β7i (Maternal depressionti)+eti

Level 2:

β0i = γ00 + γ01(Maternal average sleep patterni) + γ02 (Socioeconomic riski) + γ03 (Maternal agei) + u0i

β1i = γ10 + γ11(Maternal average sleep patterni) + u1i

β2i-7i = γ20–70.

First, maternal sleep pattern variables were included at level-1 (i.e., each time point) and were person-mean centered (i.e., centered on each mother’s average score across all age points) to represent the within-person variations of sleep patterns. Estimates of within-person effects (γ20) would indicate how deviations in the mother’s own sleep patterns from her own average (e.g., longer/shorter sleep period than usual, increased/decreased variability in sleep period than usual, later/earlier fall asleep time than usual) were related to her bedtime EA. Each mother’s average score of sleep patterns across all infant age points was included at level-2 (i.e., individual level) and was grand-mean centered to reflect between-person differences. The effect of this predictor (γ01) would represent how mothers’ average sleep patterns predicted their bedtime EA. The interactions between infant age and maternal sleep patterns (γ30 and γ11 for within- and between-person interaction, respectively) were also included as additional predictors in the model to test whether within- and between-person effects of maternal sleep patterns on bedtime EA differed by infant age. The effects of different maternal sleep pattern variables (i.e., fall asleep time, sleep period, variability in sleep period) were tested separately.

When significant interactions between maternal sleep patterns and infant age were detected, post-hoc analyses were conducted by centering infant age at each time point to determine whether there were significant associations between maternal sleep patterns and bedtime EA at the specific time point. These simple slope tests were done to help interpret and visualize the significant interaction terms. It has been argued that the test of the relations between sleep patterns and EA using re-centering is much more powerful statistically, compared to a separate analysis involving only the data at a specific time point (e.g., Whisman & McClelland, 2005).

All control variables were centered prior to analysis. Specifically, maternal age, depression, and socioeconomic risk were grand-mean centered. Infant sleep arrangements were coded into three dummy variables with the solitary sleep category as the reference category. Infant age was centered at 1 month.

Results

Preliminary Analyses

Means, standard deviations and bivariate correlations were calculated for maternal EA and sleep patterns to test if maternal EA at infant’s bedtime was associated with maternal sleep patterns. As shown in Table 1, stability of maternal EA across three time points was moderate-to-strong (rs = .43 to .61) and stability of maternal fall asleep time and sleep period were moderate-to-strong (rs = .48 to .63 for fall asleep time, and rs = .39 to .46 for sleep period). However, the stability of maternal variability in sleep period was low (rs = .12 to .18) across infant’s age. Maternal fall asleep time was significantly associated with sleep period at each time point (rs = −.37 to −.61), but the associations between variability in sleep period and the other two sleep pattern indicators (i.e., fall asleep time and sleep period) were relatively low and unstable across infant’s age (rs = −.20 to .39). The correlations between maternal bedtime EA and sleep pattern indicators were stronger at 3 and 6 months than at 1 month.

Table 1.

Descriptive Statistics and Bivariate Correlation of Maternal Average Bedtime, Average Sleep period, Variability in Sleep period and Emotion Availability

Variable 1 2 3 4 5 6 7 8 9 10 11 M SD
1 Bedtime EA, 1 mos — 0.22 2.99
2 Bedtime EA, 3 mos .58** — 0.02 3.04
3 Bedtime EA, 6 mos .43** .61** — 0.13 3.04
4 Fall asleep time, 1 mos −.14 −.25* −.13 — 23:35 01:14
5 Fall asleep time, 3 mos −.22* −.35** −.26* .48** — 23:33 01:15
6 Fall asleep time, 6 mos −.12 −.43** −.34** .55** .63** — 23:26 01:05
7 Sleep period, 1 mos −.02 .08 .07 −.61** −.19* −.29** — 8.22 1.30
8 Sleep period, 3 mos −.24* −.20 −.05 −.08 −.37** −.19* .39** — 7.89 1.03
9 Sleep period, 6 mos −.11 .19 .26* −.34** −.37** −.52** .46** .41** — 7.69 0.92
10 Vsp, 1 mos −.14 −.23* −.21* −.04 .16 .19* .06 −.06 −.12 — 1.26 0.79
11 Vsp, 3 mos −.44** −.53** −.26* .42** .17 .34** −.08 .39** −.09 .14 — 1.20 1.00
12 Vsp, 6 mos −.38** −.39** −.40** .18* .26** .21* .03 −.08 −.20* .12 .18* 1.17 0.68
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Notes. EA = Maternal emotion availability; Vsp = Variability in sleep period; Mos = Months. Sleep period and variability in sleep period reflected in hours. The composite scores of EA created by summing the z scores of the four EA subscales were used.

*

p < .05

**

p < .01.

The relations between potential covariates (i.e., maternal age, race, child gender, maternal depression, socioeconomic risk and infant sleep arrangements) and maternal EA at each time point were also tested using Pearson correlation and one-way analysis of variance (ANOVA) to determine whether each covariate needed to be included into the models. As expected, maternal age was significantly and positively related to maternal EA at 1 month (r = .302, p = .002). The correlations between maternal EA at each time point and socioeconomic risk were significant and, as expected, negative (r = −.29, p = .004 at 1 month, r = −.33, p = .001 at 3 months, and r = −.33, p = .001 at 6 months). In addition, maternal depressive symptoms were inversely and marginally associated with maternal EA at 6 months (r = −.19, p = .067). One-way ANOVA indicated that at 6 months, group difference of maternal EA was significant among infant sleep arrangement groups (F[3, 85] = 3.613, p = .016). No other significant differences were found. Therefore, maternal age, depressive symptoms, socioeconomic risk and infant sleep arrangements were entered into all models as covariates.

Primary Analyses

The change of maternal EA across time points.

The unconditional growth model examining the linear change in maternal bedtime EA was tested first. After controlling maternal age, depression, socioeconomic risk and infant sleep arrangements, maternal bedtime EA was relatively consistent across three time points, b = −0.07, SE = 0.08, p = .408. However, as shown in Table 2, the change of maternal bedtime EA did vary significantly across individuals (σu12 = 0.19, SE = 0.10, p = .036).

Table 2.

Fixed and random effects for model predicting maternal bedtime EA from maternal sleep patterns

Unconditional Model Model 1: Sleep Period Model 2: Variability in Sleep Period Model 3: Fall Asleep Time
Effect Estimate (S.E.) t/zb Estimate (S.E.) t/zb Estimate (S.E.) t/zb Estimate (S.E.) t/zb
Fixed
   Intercept, γ00 0.40 (0.36) 1.11 0.45 (0.36) 1.23 0.36 (0.32) 1.13 0.31 (0.36) 0.86
   Infant age, γ10 −0.07 (0.08) −0.83 −0.07 (0.08) −0.91 −0.10 (0.07) −1.41 −0.07 (0.08) −0.85
   Deviations in sleep pattern, γ20 — — −0.12 (0.29) −0.43 0.46 (0.31) 1.49 0.28 (0.32) 0.90
   Average sleep pattern, γ01 — — −0.28 (0.33) −0.83 −2.53 (0.42) −6.07*** −0.56 (0.28) −1.99†
   Infant age× Deviations in sleep pattern, γ30 — — 0.08 (0.12) 0.62 −0.37 (0.14) −2.66* −0.22 (0.11) −1.93†
   Infant age× Average sleep pattern, γ11 — — 0.21 (0.09) 2.37* 0.12 (0.13) 0.92 −0.04 (0.07) −0.56
   Maternal age, γ03 −0.10 (0.07) −1.32 −0.08 (0.07) −1.11 −0.02 (0.06) −0.34 −0.07 (0.07) −0.94
   Maternal depression, γ70 −0.02 (0.03) −0.83 −0.03 (0.03) −1.03 −0.02 (0.02) −0.65 −0.02 (0.03) −0.64
   Socioeconomic risk, γ02 −0.36 (0.11) −3.38** −0.36 (0.11) −3.37** −0.16 (0.10) −1.69† −0.30 (0.10) −2.86**
   Bed sharinga, γ40 −0.26 (0.63) −0.42 −0.12 (0.63) −0.18 0.19 (0.58) 0.33 −0.25 (0.62) −0.40
   Room sharinga, γ50 −0.35 (0.42) −0.83 −0.42 (0.42) −1.00 −0.36 (0.39) −0.93 −0.24 (0.42) −0.58
   Combinationa, γ60 −0.22 (0.51) −0.42 −0.18 (0.51) −0.35 −0.08 (0.48) −0.17 −0.16 (0.51) −0.31
Random
   Intercept, σu02 5.34 (1.33) 4.03*** 5.09 (1.32) 3.87*** 2.62 (1.05) 2.49** 4.78 (1.28) 3.72***
   Infant age, σu12 0.19 (0.10) 1.80* 0.13 (0.10) 1.30† 0.10 (0.10) 1.04 0.15 (0.10) 1.43†
   Covariance between intercept and infant age, σu01 −0.55 (0.31) −1.78† −0.44 (0.30) −1.47 −0.15 (0.28) −0.53 −0.50 (0.30) −1.66†
   Residual, σe2 3.41 (0.65) 5.22*** 3.54 (0.69) 5.13*** 3.57 (0.66) 5.39*** 3.59 (0.69) 5.21***
Open in a new tab

Notes. N = 142. The composite scores of EA created by summing the z scores of the four EA subscales were used. Sleep period and variability in sleep period reflected in hours. Deviations in sleep pattern were calculated by centering on each mother’s average score of sleep pattern across all age points. Average sleep pattern was grand-mean centered. Infant age was centered at 1 month. Maternal age, depression and socioeconomic risk were grand-mean centered.

a

Infant sleep arrangements were coded into three dummy variables (i.e., “room sharing”, “bed sharing”, and “combination”) with the “solitary sleep” as the reference category.

b

t scores were calculated for fixed effects, and z scores were calculated for random effects.

†

p<.10

*

p< .05

**

p< .01

***

p<.001.

Maternal sleep period as the predictor.

Next, a conditional model including maternal sleep period and the interaction term with infant age was examined. Results indicated a significant between-person interaction between maternal average sleep period and infant age (b = 0.21, SE = 0.09, p = .022, see Model 1 in Table 2). The results of simple slope test indicated that the link between maternal average sleep period and bedtime EA was not significant at infants’ 1 month or 3 months (b = −0.28, SE = 0.33, p = .410 at 1 month; b = 0.11, SE = 0.27, p = .672 at 3 months). However, at 6 months, mothers with longer average sleep periods had significantly higher bedtime EA scores than mothers with shorter average sleep period (b = 0.76, SE = 0.35, p = .038), as shown in Figure 1. No significant within-person association between maternal sleep period and bedtime EA was found.

Figure 1.

Figure 1.

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Between-person interaction between infant age and maternal average sleep period predicting maternal bedtime EA. The composite scores of EA created by summing the z scores of the four EA subscales were used. Maternal average sleep period was grand-mean centered.

Variability in sleep period (VSP) as the predictor.

A conditional model including maternal variability in sleep period and the interaction term with infant age was fitted. As shown in Table 2 (Model 2), there were significant associations between maternal VSP and bedtime EA at the between-person level, such that mothers who had greater average VSP showed lower bedtime EA (b = −2.53, SE = 0.42, p < .001). Moreover, at the within-person level, maternal deviations in VSP significantly interacted with infant age (b = −0.37, SE = 0.14, p = .011). Specifically, as shown in Figure 2, maternal deviations in VSP did not significantly predict bedtime EA when infants were 1 month or 3 months (b = 0.46, SE = 0.31, p = .144 at 1 month; b = −0.23, SE = 0.20, p = .248 at 3 months). However, when mothers had higher VSP than usual (i.e., compared to one’s own cross-time average) at infants’ 6 months, they also had significant poorer bedtime EA (b = −1.37, SE = 0.49, p = .008).

Figure 2.

Figure 2.

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Within-person interaction between infant age and maternal variability in sleep period (VSP) predicting maternal bedtime EA. The composite scores of EA created by summing the z scores of the four EA subscales were used. Within-person variations of VSP were calculated by person-mean centering on each mother’s average VSP score across all age points.

Fall asleep time as the predictor.

A conditional model including maternal fall asleep time and the interaction term with infant age was also tested. The results indicated that the between-person effects of maternal fall asleep time on bedtime EA were marginally significant, such that mothers with later average fall asleep time had lower bedtime EA (b = −0.56, SE = 0.28, p = .053, see Model 3 in Table 2). At the within-person level, the interaction between maternal deviations in fall asleep time and infant age approached significance (b = −0.22, SE = 0.11, p = .060). As shown in Figure 3, simple slope test indicated that maternal deviations in fall asleep time did not predict bedtime EA at 1 month or 3 months (b = 0.28, SE = 0.32, p = .373 at 1 month; b = −0.13, SE = 0.22, p = .573 at 3 months). However, when mothers fell asleep later than usual (i.e., their own average fall asleep time) at infants’ 6 months, they had relatively poorer bedtime EA (near-significant trend: b = −0.80, SE = 0.40, p = .052).

Figure 3.

Figure 3.

Open in a new tab

Within-person interaction between infant age and maternal fall asleep time predicting maternal bedtime EA. The composite scores of EA created by summing the z scores of the four EA subscales were used. Within-person variations of fall asleep time were calculated by person-mean centering on each mother’s average fall asleep time score across all age points.

Discussion

The present study is among the first to examine whether irregular sleep patterns predicted observed maternal parenting quality at bedtime across the first 6 months of infants’ life. Our results demonstrated that mothers with irregular sleep patterns, especially greater average variability in sleep period and later average fall asleep time, had poorer parenting quality with infants at bedtime, compared to mothers with more regular, consistent sleep patterns. We also found that both between- and within-person effects of maternal sleep on bedtime parenting quality changed with infants age. Specifically, at the between-person level, when infants were 6 months, mothers who had shorter average sleep period had poorer bedtime parenting quality. At the within-person level, mothers also showed poorer bedtime parenting quality when they had increased variability in sleep period than usual, and later fall asleep times than usual at infants’ 6 months. However, these associations were not significant when infants were at 1 or 3 months. These results suggest that parent sleep regulation and sleep hygiene may be particularly important individual factors for the quality of caregiving.

Change in Maternal Emotional Availability at Bedtime

The correlation analyses and unconditional growth model both revealed that maternal bedtime EA was relatively stable across infants’ first 6 months. These results are consistent with a previous longitudinal study demonstrating the high stability of maternal EA at bedtime during the first year of infants’ life (Kim et al., 2017). At the same time, it is important to note that individual differences were found in the change of bedtime EA from 1 to 6 months, suggesting that mothers’ adaptations to infants’ emerging developmental capacities during the first 6 months differed across families. In the present study, we found that at least one explanation for these individual differences in maternal EA could be traced to differences in maternal sleep patterns.

The Main Effect of Irregular Maternal Sleep Patterns

The hypothesis that irregular maternal sleep patterns would be associated with poor bedtime EA across infant age was supported by significant between-person associations. Specifically, our results revealed that mothers with greater average variability in sleep period and later average fall asleep across the first 6 months had poorer bedtime EA, compared to other mothers. There was only a non-significant trend for the between-person effects of average fall asleep time on bedtime EA, which should be interpreted with caution. However, the overall findings are consistent with previous cross-sectional studies identifying poor maternal sleep as a significant predictor of poor parenting of mothers with older children (Brand et al., 2009; Tu et al., 2018; McQuillan et al., 2019). Tu et al. (2018) postulated that irregular sleep patterns might contribute to parental fatigue, which in turn reduces parents’ ability to enforce family rules and disciplines and increase the instances of permissive parenting. In addition, sleep deprivation and fatigue are known to disrupt parental cognitive, emotional and family functioning, such as attentional impairment (e.g., Walker, 2009), difficulties in emotion regulation (e.g., Kahn et al., 2013) and poor parent-child relationships (e.g., Tikotzky, 2016). The present results suggest that impairments in maternal daily functioning caused by irregular sleep patterns undermined mothers’ capacities for providing sensitive and responsive caregiving to infants, especially during the early post-partum period when maternal sleep can be heavily influenced by infant nighttime demands (Insana et al., 2014).

Interactions between Irregular Maternal Sleep Patterns and Infant Age

Our study also revealed significant interactions between irregular maternal sleep patterns and infant age across the first 6 months at both between- and within-person levels. Specifically, at the between-person level, mothers with shorter average sleep period had poorer bedtime EA when infants were 6 months but not at earlier ages, compared to mothers with longer average sleep period. At the within-person level, when mothers had increased variability in sleep period than usual and later fall asleep times than usual, they also showed poorer bedtime EA than usual, but again only at 6 months. Although the finding on fall asleep times should be interpreted with caution because the within-person interaction between infant age and maternal fall asleep time approached but did not achieve significance, it is compatible with the findings of other sleep pattern predictors mentioned above. The overall patterns of these findings could be explained by the increased demands on mothering in response to the emerging developmental capacities of infants by 6 months, compared to earlier age points, in perceptual-motor (e.g., visual acuity and movement), gross motor (e.g., crawling), cognitive (e.g., attention, memories, and learning abilities), language, and socio-emotional domains (e.g., sensitivity to social cues, emotion expression and recognition) (Bornstein, Arterberry, & Lamb, 2014). Stated differently, 6-month-olds are able to interact with others in more varied, complex ways, and have increased capacities for interacting with their environments, compared to 1-month-olds. The emergent developmental and behavioral competencies of infants by 6 months may place more demands on parents, which could be especially challenging for mothers with disrupted daily functioning resulting from irregular sleep patterns. To our knowledge, this is the first study providing evidence of both between-and within-person effects of maternal sleep patterns on parenting quality longitudinally during the early post-partum period.

Limitations and Future Directions

Several limitations of this study should be acknowledged. First, the sample in the present study was composed of primarily White, relatively low-risk, middle-class families with two parents in the household, and the enrollment rate (18.6%) of the current study was relatively low. The homogeneity and low enrollment rate limited the generalizability to more diverse populations. Future studies examining linkages between parental sleep patterns and parenting quality need to be done in samples with greater racial-ethnic diversity to understand more clearly whether and how linkages between parental sleep and parenting of infants are differentially impacted by racial, ethnic, and socio-demographic differences.

The use of self-reported assessment of maternal sleep patterns is another potential limitation in the present study. Although daily dairies provide more detailed information about sleep patterns compared to single-point-in-time assessments, self-report bias may still exist, and it could be difficult for mothers to report accurately their sleep every day across seven days of data collection. Because of the lack of accurate information on the duration of each night waking, the sleep period used in the current study failed to account for the night wakings, which is a limitation. However, the self-reported sleep period was highly correlated with actigraphy-assessed sleep duration, suggesting the adequate reliability of this indicator. Future studies can benefit from including objective assessments of parental sleep patterns (e.g., actigraphy). Indeed, studies that make use of multiple methods of sleep assessment allow investigators to cross-reference findings across measures and increase confidence in study results (Van Den Berg et al., 2008).

In addition, although the current study partialed out the effects of multiple confounding variables, parenting is multiply determined and could be impacted by a variety of additional variables. For example, research has suggested that maternal anxiety (Seymour, Giallo, Cooklin, & Dunning, 2015), infant sleep quality (Philbrook & Teti, 2016), and infant temperament (Wittig & Rodriguez, 2019) may also influence parenting during infancy and should be considered in future work on parenting quality during infant bedtimes.

Also, the links between parenting and parental sleep could be bidirectional. Although we interpreted our results as maternal sleep influencing maternal parenting quality at bedtime, it is also possible that maternal parenting performance at a previous time point could influence maternal sleep at a later time. Future studies testing cross-lagged associations between parental sleep and parenting, to address the potential bidirectional and dynamic linkages between sleep and parenting, are needed.

Finally, fathers were not included in the present study, because of the low number of fathers who were captured on camera during infant bedtimes (approximately 25% of the full sample), precluding meaningful analyses. Because a majority of couples co-sleep at night, and that studies suggest bidirectional associations between couple relationship quality and sleep problems (e.g., Troxel, Robles, Hall, & Buysse, 2007), it is possible that paternal sleep and marital quality also influenced maternal sleep patterns and bedtime parenting quality. Future studies should examine linkages between sleep and parenting from a broader, family-based lens, testing whether relations between parental sleep patterns and bedtime parenting are found in fathers as well as mothers and to determine to what degree sleep patterns and parenting quality of one partner are affected by sleep patterns in the other.

Conclusions

Despite these limitations, the current study is among the first to demonstrate relations between maternal irregular sleep patterns and parenting quality at bedtime during the early post-partum period, using a design that enabled assessments of change over time, direct observations of parenting during the naturalistic context of infant bedtime, daily diary assessments of parent sleep, and multiple indicators of maternal sleep patterns. Our findings suggest that irregular maternal sleep patterns are significant predictors of poor quality of mothering with infants at bedtime on average and would negatively impact the quality of mothering more at 6 months than younger age points.

The present study has implications for intervention, as our findings imply that parent sleep regulation and sleep hygiene should be a key component of parenting interventions, particularly during the transition to parenthood, when parent sleep is highly likely to be disrupted. Clinicians, practitioners, and interventionists may wish to incorporate parent sleep patterns into parenting intervention protocols with the understanding that good sleep hygiene and well-regulated sleep promotes better parenting.

Acknowledgments

This paper was supported by a grant from the National Institute of Health and Human Development, R01 HD052809, awarded to the third author. We thank Cori Reed, and Renee Stewart for their assistance in coordinating this project. Special thanks are given to the participating families.

Footnotes

Portions of these results were presented at the biennial International Congress on Infant Studies, Philadelphia, PA, 2018.

1

The numbers of families providing less than 5 mins bedtime mother-infant interaction were three, two and one at 1, 3 and 6 months, respectively. Each model was also conducted after excluding those six EA scores. All findings remain the same, suggesting that EA scores from relatively short observations did not bias the results.

2

We also ran models with missing data handled via Multiple Imputation (MI). The unordered categorical variables, infant sleep arrangements, were not imputed. Only two families could not be included in the final analyses because of missing data on infant sleep arrangements at all time points. Thus, models were conducted using 100 imputed datasets in SAS with 165 participants. The results using MI were similar to those reported using ML. All interpretations of the results did not change, suggesting that using different approaches to handling missing data did not influence our findings.

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