Longitudinal Associations Between Maternal Sleep Quality and Infant-Mother Attachment: The Mediating Role of Maternal Emotional Availability

• In Event: Sleep as a Predictor and Outcome of the Parent-Infant Relationship

Abstract

Attachment theory establishes parenting quality as the final common pathway in predicting quality of infant-parent attachment (Ainsworth, Blehar, Waters, & Wall, 1978). Additionally, recent studies have found mother’s sleep quality to be strongly linked to parenting quality (Bai, Whitesell, & Teti, 2019). Because mothers’ sleep may be compromised during the transition to parenthood in the first year of infant’s life, it is important to examine the negative effects of poor sleep quality in mothers during this period on infant outcomes. The present study thus explored the longitudinal linkages between maternal sleep quality and infant-mother attachment as mediated by maternal emotional availability at bedtime.

One hundred sixty-seven infants and their families were used in this study, drawn from Project SIESTA-II, a federally funded longitudinal study of parenting, infant sleep, and infant development across the first two years of life. The current study focused on measures of maternal sleep quality and maternal emotional availability at bedtime from 1, 3, 6, 9, and 12 months, as well as the Attachment Q-sort (AQS; Waters, 1995) from 12, 18, and 24 months. To assess mother’s sleep quality, sleep fragmentation, sleep efficiency, and wake duration in minutes were recorded using the AW-64 actiwatches (Philips/Respironics, Inc.) across seven consecutive days. In addition, observational coding of maternal emotional availability at bedtime was done using the Emotional Availability Scales (EAS; Biringen, Robinson, & Emde, 1998), and coders who were blind to the observations of emotional availability scored the quality of infant-mother attachment using the AQS.

All analyses were tested using the bias-corrected bootstrap confidence intervals with 10,000 samples using the lavaan package in R (Rosseel, 2012). Separate mediation analyses were conducted for each of the maternal sleep quality assessments (sleep fragmentation, sleep efficiency, and wake duration in minutes) for the attachment outcomes at each time point (12, 18, and 24 months). All models used maternal sleep quality as the predictor, maternal emotional availability as the mediator, and infant-mother attachment as the outcome variable (Figure 1).

The results indicated that there was a significant indirect linkage between all three assessments of maternal sleep quality and infant to mother attachment quality at 12 months and 18 months, but not at 24 months (Table 1). Importantly, there were no direct effects of maternal sleep quality on attachment quality at either 12 and 18 months after accounting for mediation. At all timepoints, maternal sleep quality was significantly linked to mothering at bedtime. The estimates of all paths from all nine models are reported in Table 1.

These findings suggest that mother’s sleep quality in the first year of infant’s life may have an indirect predictive influence on the infant’s attachment quality to the mother, via its influence on mothering at bedtime, at least until the infant reaches 18 months of age. Discussion will focus on incorporating efforts to improve mother’s sleep in future parenting interventions.



 

Authors

• Christine Kim, Pennsylvania State University, University Park
  Presenting Author

• Liu Bai, Pennsylvania State University, University Park
  Non-Presenting Author

• Brian Crosby, Pennsylvania State University
  Non-Presenting Author

• Douglas M Teti, The Pennsylvania State University
  Non-Presenting Author