title: Relationships between parental sleep quality, fatigue, cognitions about infant sleep, and parental depression pre and post-intervention for infant behavioral sleep problems.
abstract: Maternal and paternal depression has been associated with infants' behavioral sleep problems. Behavioral sleep interventions, which alter parental cognitions about infant sleep, have improved infant sleep problems. This study reports relationships between parental depression, fatigue, sleep quality, and cognitions about infant sleep pre and post-intervention for a behavioral sleep problem.
  
  
  
  This secondary analysis of data from Canadian parents (n = 455), with healthy infants aged 6-to-8-months exposed to a behavioral sleep intervention, examined baseline data and follow-up data from 18 or 24 weeks post intervention (group teaching or printed material) exposure. Parents reported on sleep quality, fatigue, depression, and cognitions about infant sleep. Data were analyzed using Pearson's r and stepwise regression analysis.
  
  
  
  Parents' fatigue, sleep quality, sleep cognitions, and depression scores were correlated at baseline and follow-up. At baseline, sleep quality (b = .52, 95% CI .19-.85), fatigue (b = .48, 95% CI .33-.63), doubt about managing infant sleep (b = .44, 95% CI .19-.69), and anger about infant sleep (b = .69, 95% CI .44-.94) were associated with mothers' depression. At baseline, fathers' depression related to sleep quality (b = .42, 95% CI .01-.83), fatigue (b = .47, 95% CI .32-.63), and doubt about managing infant sleep (b = .50, 95% CI .24-.76). At follow-up, mothers' depression was associated with sleep quality (b = .76, 95% CI .41-1.12), fatigue (b = .25, 95% CI .14-.37), doubt about managing infant sleep (b = .44, 95% CI .16-.73), sleep anger (b = .31, 95% CI .02-.59), and setting sleep limits (b = -.22, 95% CI -.41-[-.03]). At follow-up, fathers' depression related to sleep quality (b = .84, 95% CI .46-1.22), fatigue (b = .31, 95% CI .17-.45), sleep doubt (b = .34, 95% CI .05-.62), and setting sleep limits (b = .25, 95% CI .01-.49).
  
  
  
  Mothers' and fathers' cognitions about infant sleep demonstrate complex relationships with their depression scores. While mothers' setting sleep limit scores are associated with decreased depression scores, fathers' setting limits scores are associated with increased depression scores. Parental doubts about managing infant sleep and difficulties with setting sleep limits require attention in interventions.
authors.affiliation: University of British Columbia School of Nursing, T. 201, 2211 Wesbrook Mall, Vancouver, BC, V6T 2B5, Canada. wendy.hall@ubc.ca.
authors.forename: Wendy A
authors.initials: WA
authors.lastname: Hall
authors.affiliation: School of Nursing, University of British Columbia, Vancouver, BC, Canada.
authors.forename: Melissa
authors.initials: M
authors.lastname: Moynihan
authors.affiliation: South Community Health Centre, Vancouver Coastal Health, Vancouver, BC, Canada.
authors.forename: Radhika
authors.initials: R
authors.lastname: Bhagat
authors.affiliation: Maternal Child Program, Vancouver Coastal Health, Vancouver, BC, Canada.
authors.forename: Joanne
authors.initials: J
authors.lastname: Wooldridge
mesh_terms: D056044:Actigraphy; D000328:Adult; D003071:Cognition / Q000502:physiology*; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D003863:Depression / Q000150:complications* / Q000523:psychology; D005220:Fathers / Q000523:psychology; D005221:Fatigue / Q000150:complications* / Q000523:psychology; D005260:Female; D006801:Humans; D007223:Infant; D018730:Infant Behavior; D008297:Male; D008875:Middle Aged; D009035:Mothers / Q000523:psychology; D011247:Pregnancy; D012890:Sleep / Q000502:physiology*; D012893:Sleep Wake Disorders / Q000209:etiology / Q000523:psychology / Q000628:therapy*; D055815:Young Adult
keywords: Depression; Fatigue; Infant; Sleep cognitions; Sleep problems