Sleep and Attachment in Preterm Infants

Infants born preterm are at elevated risk for socioemotional difficulties; however, factors contributing to this risk are largely understudied. Within the present study, we explored infant sleep as a biosocial factor that may play a role in infant socioemotional development. Within a prospective longitudinal design, we examined parent‐reported sleep patterns and observed parenting quality as predictors of infant–mother attachment in 171 infants born preterm. Using structural equation modeling, we examined main effect and moderator models linking infant sleep patterns and parenting with attachment security. Sleep patterns characterized by more daytime sleep and positive/responsive parenting predicted infant attachment security. Parent‐reported nighttime sleep patterns were unrelated to attachment in this sample of infants born preterm. These results indicate that daytime sleep and parenting quality may be important for emerging attachment relationships in infants born preterm. Zusammenfassung Frühgeborene Säuglinge unterliegen einem erhöhten Risiko an sozioemotionalen Schwierigkeiten zu erkranken. Nichtsdestotrotz wurden Faktoren, die zu diesem Risiko beitragen bislang weitgehend vernachlässigt. Im Rahmen der vorliegenden Studie wurde das Schlafverrhalten des Säuglings als biosozialer Faktor untersucht, der in der sozioemotionalen Entwicklung von Säuglingen eine Rolle spielen könnte. Innerhalb eines prospektiven longitudinalen Designs, untersuchten wir die von Eltern berichteten Schlafmuster sowie beobachtete Erziehungsqualität als Prädiktoren der Bindung zwischen Mutter und Säugling in 171 frühgeborenen Säuglingen. Unter Verwendung eines Strukturgleichungsmodells prüften wir Haupteffekt‐ und Moderatormodelle, die die Schlafmuster des Säuglings mit Erziehungsverhalten der Eltern und Bindungssicherheit koppelten. Schlafmuster, die durch vermehrten Tagesschlaf gekennzeichnet waren und positives/ responsives Erziehungsverhalten sagten größere Bindungssicherheit des Säuglings vorher. Von Eltern berichtete nächtliche Schlafmuster standen in keiner Beziehung zur Bindungssicherheit der Stichprobe von frühgeborenen Säuglingen. Diese Ergebnisse weisen darauf hin, dass Tagesschlaf und elterliche Erziehungsqualität bedeutsam für die aufkeimenden Bindungsbeziehungen von frühgeborenen Säuglingen sind. Resumen Los infantes nacidos prematuramente se encuentran bajo un elevado riesgo de dificultades emocionales sociales. Sin embargo, los factores que contribuyen a este riesgo no han sido estudiados suficientemente. Dentro del presente estudio, exploramos el hábito de dormir del infante como un factor bio‐social que pudiera jugar un papel en el desarrollo emocional social del infante. Dentro de un probable diseño longitudinal, examinamos los patrones de dormir reportados por la madre y observamos la calidad de la crianza como factores de predicción de la afectividad entre madre e infante en 171 infantes nacidos prematuramente. Usando un modelo de ecuación estructural, examinamos modelos de efecto principal y moderadores que conectaban los patrones de dormir del infante y la crianza con la seguridad de afectividad. Los patrones caracterizados por más tiempo diurno de dormir y una crianza positiva/sensible predijeron la seguridad de afectividad del infante. Los patrones de dormir nocturnos reportados por la madre no tuvieron relación con la afectividad en este grupo muestra de infantes nacidos prematuramente. Estos resultados indican que los hábitos de dormir diurnos y la calidad de la crianza pudieran ser importantes para las nacientes relaciones afectivas en infantes nacidos prematuramente. Résumé Les bébés nés avant terme sont à un risque élevé de difficultés socio‐émotionnelles. Cependant les facteurs contribuant à ce risque sont grandement sous‐étudiés. Nous avons exploré dans cette étude le sommeil du bébé en tant qu’un facteur biosocial qui peut jouer un rôle dans le développement socio‐émotionnel du bébé. Au sein d’une structure longitudinale potentielle nous avons examiné les patterns de sommeil bébé‐mère et observé la qualité du parentage en tant que facteur de prédiction de l’attachement bébé‐mère chez 171 bébés nés prématurés. En utilisant un modèle structurel d’équation nous avons examiné l’effet principal et les modèles modérateurs principaux liant les patterns de sommeil du bébé et le parentage avec une sécurité d’attachement. Les patterns de sommeil caractérisés par plus de sommeil durant la journée et un parentage positif/réceptif ont prédit la sécurité d’attachement du bébé. Les patterns de sommeil dont ont fait état les parents n’étaient pas liés à l’attachement chez cet échantillon de bébés nés avant terme. Ces résultats indiquent que le sommeil dans la journée et la qualité de parentage peuvent s’avérer importants pour les relations d’attachement émergentes chez les bébés nés avant terme.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/96377/1/imhj21374.pd

The relationship between prior night's sleep and measures of infant imitation.

We examined whether sleep quality during the night and naps during the day preceding a learning event are related to memory encoding in human infants. Twenty-four 6- and twenty-four 12-month-old infants' natural sleeping behavior was monitored for 24 hr using actigraphy. After the recording period, encoding was assessed using an imitation paradigm. In an initial baseline phase, infants were allowed to interact with the stimulus to assess spontaneous production of any target actions. Infants then watched an experimenter demonstrate a sequence of three target actions and were immediately given the opportunity to reproduce the demonstrated target actions to assess memory encoding. Analyses revealed significant correlations between nighttime sleep quality variables (sleep efficiency, sleep fragmentation) and immediate imitation in 6-month-olds, but not in 12-month-olds. High sleep quality in the preceding night was thus positively associated with next day's memory encoding in 6-month-old infants. © 2016 Wiley Periodicals, Inc. Dev Psychobiol 9999: 1-12, 2016

Sleep habits and sleep disturbances in Dutch children: a population-based study

Sleep disorders can lead to significant morbidity. Information on sleep in healthy children is necessary to evaluate sleep disorders in clinical practice, but data from different societies cannot be simply generalized. The aims of this study were to (1) assess the prevalence of sleep disturbances in Dutch healthy children, (2) describe sleep habits and problems in this population, (3) collect Dutch norm data for future reference, and (4) compare sleep in children from different cultural backgrounds. A population-based descriptive study was conducted using the Children’s sleep habits questionnaire and the sleep self-report. One thousand five hundred seven proxy-reports and 262 self-reports were analyzed. Mean age was 8.5 years (95% confidence interval, 8.4–8.6), 52% were boys. Sleep problems in Dutch children were present in 25%, i.e., comparable to other populations. Sleep habits were age-related. Problem sleepers scored significantly higher on all scales. Correlations between parental and self-assessments were low to moderate. Dutch children had significantly more sleep disturbances than children from the USA and less than Chinese children. Cognitions and attitudes towards what is considered normal sleep seem to affect the appraisal of sleep, this probably accounts partly for cultural differences. For a better understanding of cultural influences on sleep, more information on these determinants and the establishment of cultural norms are mandatory

Adherence to 24-Hour Movement Guidelines for the Early Years and associations with social-cognitive development among Australian preschool children

Background: The new Australian 24-Hour Movement Guidelines for the Early Years recommend that, for preschoolers, a healthy 24-h includes: i) ≥180 min of physical activity, including ≥60 min of energetic play, ii) ≤1 h of sedentary screen time, and iii) 10–13 h of good quality sleep. Using an Australian sample, this study reports the proportion of preschool children meeting these guidelines and investigates associations with social-cognitive development. Methods: Data from 248 preschool children (mean age = 4.2 ± 0.6 years, 57% boys) participating in the PATH-ABC study were analyzed. Children completed direct assessments of physical activity (accelerometry) and social cognition (the Test of Emotional Comprehension (TEC) and Theory of Mind (ToM)). Parents reported on children’s screen time and sleep. Children were categorised as meeting/not meeting: i) individual guidelines, ii) combinations of two guidelines, or iii) all three guidelines. Associations were examined using linear regression adjusting for child age, sex, vocabulary, area level socio-economic status and childcare level clustering. Results: High proportions of children met the physical activity (93.1%) and sleep (88.7%) guidelines, whereas fewer met the screen time guideline (17.3%). Overall, 14.9% of children met all three guidelines. Children meeting the sleep guideline performed better on TEC than those who did not (mean difference [MD] = 1.41; 95% confidence interval (CI) = 0.36, 2.47). Children meeting the sleep and physical activity or sleep and screen time guidelines also performed better on TEC (MD = 1.36; 95% CI = 0.31, 2.41) and ToM (MD = 0.25; 95% CI = −0.002, 0.50; p = 0.05), respectively, than those who did not. Meeting all three guidelines was associated with better ToM performance (MD = 0.28; 95% CI = −0.002, 0.48, p = 0.05), while meeting a larger number of guidelines was associated with better TEC (3 or 2 vs. 1/none, p < 0.02) and ToM performance (3 vs. 2, p = 0.03). Conclusions: Strategies to promote adherence to the 24-Hour Movement Behaviour Guidelines for the Early Years among preschool children are warranted. Supporting preschool children to meet all guidelines or more guidelines, particularly the sleep and screen time guidelines, may be beneficial for their social-cognitive development

Baby Business: a randomised controlled trial of a universal parenting program that aims to prevent early infant sleep and cry problems and associated parental depression

<p>Abstract</p> <p>Background</p> <p>Infant crying and sleep problems (e.g. frequent night waking, difficulties settling to sleep) each affect up to 30% of infants and often co-exist. They are costly to manage and associated with adverse outcomes including postnatal depression symptoms, early weaning from breast milk, and later child behaviour problems. Preventing such problems could improve these adverse outcomes and reduce costs to families and the health care system. Anticipatory guidance-i.e. providing parents with information about normal infant sleep and cry patterns, ways to encourage self-settling in infants, and ways to develop feeding and settling routines <it>before </it>the onset of problems-could prevent such problems. This paper outlines the protocol for our study which aims to test an anticipatory guidance approach.</p> <p>Methods/Design</p> <p>750 families from four Local Government Areas in Melbourne, Australia have been randomised to receive the <it>Baby Business </it>program (intervention group) or usual care (control group) offered by health services. The <it>Baby Business </it>program provides parents with information about infant sleep and crying via a DVD and booklet (mailed soon after birth), telephone consultation (at infant age 6-8 weeks) and parent group session (at infant age 12 weeks). All English speaking parents of healthy newborn infants born at > 32 weeks gestation and referred by their maternal and child health nurse at their first post partum home visit (day 7-10 postpartum), are eligible. The primary outcome is parent report of infant night time sleep as a problem at four months of age and secondary outcomes include parent report of infant daytime sleep or crying as a problem, mean duration of infant sleep and crying/24 hours, parental depression symptoms, parent sleep quality and quantity and health service use. Data will be collected at two weeks (baseline), four months and six months of age. An economic evaluation using a cost-consequences approach will, from a societal perspective, compare costs and health outcomes between the intervention and control groups.</p> <p>Discussion</p> <p>To our knowledge this is the first randomised controlled trial of a program which aims to prevent both infant sleeping and crying problems and associated postnatal depression symptoms. If effective, it could offer an important public health prevention approach to these common, distressing problems.</p> <p>Trial registration number</p> <p>ISRCTN: <a href="http://www.controlled-trials.com/ISRCTN63834603">ISRCTN63834603</a></p

FMR1 premutation and full mutation molecular mechanisms related to autism

Fragile X syndrome (FXS) is caused by an expanded CGG repeat (>200 repeats) in the 5′ un-translated portion of the fragile X mental retardation 1 gene (FMR1) leading to a deficiency or absence of the FMR1 protein (FMRP). FMRP is an RNA-binding protein that regulates the translation of a number of other genes that are important for synaptic development and plasticity. Furthermore, many of these genes, when mutated, have been linked to autism in the general population, which may explain the high comorbidity that exists between FXS and autism spectrum disorders (ASD). Additionally, premutation repeat expansions (55 to 200 CGG repeats) may also give rise to ASD through a different molecular mechanism that involves a direct toxic effect of FMR1 mRNA. It is believed that RNA toxicity underlies much of the premutation-related involvement, including developmental concerns like autism, as well as neurodegenerative issues with aging such as the fragile X-associated tremor ataxia syndrome (FXTAS). RNA toxicity can also lead to mitochondrial dysfunction, which is common in older premutation carriers both with and without FXTAS. Many of the problems with cellular dysregulation in both premutation and full mutation neurons also parallel the cellular abnormalities that have been documented in idiopathic autism. Research regarding dysregulation of neurotransmitter systems caused by the lack of FMRP in FXS, including metabotropic glutamate receptor 1/5 (mGluR1/5) pathway and GABA pathways, has led to new targeted treatments for FXS. Preliminary evidence suggests that these new targeted treatments will also be beneficial in non-fragile X forms of autism