Parental and Infant Sleep in the Postpartum Period: Links with Parent-Infant Bonding

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

Abstract

A healthy parent-infant relationship is crucial for infant development (Kochanska, 2002). Maternal depression and mother-infant sleep disturbances in the postpartum period have both been linked to poorer mother-infant relationship (Tikotzky, 2016). However, the ways in which these interact to predict parent-infant relationship have yet to be examined. Exploring interaction/moderation effects is necessary to identify subgroups at greater risk (Goodman & Gotlib, 1999; Rutter & Sroufe, 2000). Importantly, so far, the studies on parent sleep and parent-infant relationship focused almost exclusively on mothers. However, fathers’ sleep could also be influenced by their infants’ awakenings. Accordingly, the present study was aimed at investigating: (a) the links between mothers’, fathers’ and infant sleep quality and between both parents’ perceived relationship with their infants (i.e., bonding); (b) the associations between both parents’ depressive symptoms and parent-infant bonding; (c) the interaction effect of sleep and depressive symptoms in the prediction of parent-infant bonding.

This study is part of a larger ongoing longitudinal study that started during pregnancy. Presented data were collected at two time points- 4 months postpartum (120 families), and 8 months postpartum (83 families – the data for the remaining 37 families has not been coded/collected yet). Parental and infant sleep was examined by actigraphy (an objective sleep assessment method) for 7 consecutive nights (excluding weekends). Actigraphic sleep measures included: minutes awake after sleep onset (WASO) and the number of awakenings (NW). Both parents completed the Insomnia Severity Index (ISI) and mothers filled in the Brief Infant Sleep Questionnaire (BISQ). BISQ measures included: WASO, NW, and parental perception of infant sleep as problematic (SP). Both parents completed the Edinburgh Postnatal Depression Scale (EPDS) and the Impaired Bonding sub-scale from the Postpartum Bonding Questionnaire (PBQ-IB). Higher PBQ-IB scores indicate more impaired bonding.

All correlations between EPDS and PBQ-IB were significant. PBQ-IB was associated with subjective infant and parental sleep, but not with actigraphic sleep. Interestingly, fathers’ higher PBQ-IB scores were correlated with poorer infant and paternal sleep quality (i.e., higher BISQ-NW, BISQ-WASO; BISQ-SP, ISI) at both 4 and 8 months, whereas maternal PBQ-IB was correlated with infant and maternal sleep quality (i.e., higher BISQ-SP and ISI) only at 8 months. For instance, at 8 months, longer infant WASO (BISQ) was significantly correlated with fathers’ more impaired bonding (r=.36, p=.002). Moreover, hierarchical, multiple regression analyses demonstrated a significant interaction effect between paternal EPDS and infant sleep in the prediction of fathers’ PBQ-IB. As illustrated in Figures 1, for fathers with moderate and higher EPDS scores, but not for fathers with lower EPDS scores, higher BISQ-WASO (model 1) and more BISQ-NW (model 2) were significantly associated with higher paternal PBQ-IB scores at 8 months.

Our findings may suggest that fathers may be more vulnerable than mothers to the effects of infant sleep disturbances, in terms of the quality of their bonding relationship with the infant. This seems especially relevant for fathers with elevated depressive symptoms. These findings highlight the importance of including fathers in research on parenting and infant sleep.

Authors

• Dar Ran-Peled, other Ben Gurion University of the Negev
  Presenting Author

• Avel Horwitz, Ben-Gurion University
  Non-Presenting Author

• Omer Finkelstein, Ben Gurion University
  Non-Presenting Author

• Gal Meiri, Soroka University Medical Center, Beersheva, Israel
  Non-Presenting Author

• Liat Tikotzky, Ben-Gurion University of the Negev
  Non-Presenting Author