If you have not already done so, please read Blog Posts 1 through 5 that describe how sleep is important and beneficial. I will post specific information for parents and children based on my book, “Healthy Sleep Habits, Happy Child.” Please do not be put off by my book’s length. This is a reference book. Read only the topic of interest to you.
2. MOTHERS
A Norwegian study of about 15,000 children included maternal evaluations at 18 months and concluded that concurrent maternal symptoms of anxiety or depression caused night wakings in their children and not vice versa. They wrote:
Mothers with depressive symptoms are more likely to have negative cognitions about setting limits for their children and increased doubts regarding parenting competence and to worry more often about their infant’s sleep. These mothers more easily perceived themselves as insensitive, neglectful, or even abusive toward the child if they are not highly involved at bedtime or night time, and they even tend to more often interpret their children’s crying as a sign of anxiety or distress. As a result, it is postulated that these negative cognitions even tend to affect maternal bedtime and nighttime behavior and could even result in scenarios like putting the child to sleep late, using an inconsistent bedtime routine, having maternal presence at bedtime, or sharing the bed during the night. These behaviors will interfere with the development of self-soothing skills in the child, because bedtime interactions with parents are rewarding and provide positive feedback that maintains dependence on parents. This has been suggested to lead to different sleep problems. [Others] claimed that these negative cognitions are often related to strong emotions such as guilt, shame, and anger, which serve as a negative reinforcer for any change in parenting behavior.
In a study regarding maternal depression, Dr. Johanna Petzoldt observed that “infant sleeping problems were related to maternal depressive (and comorbid anxiety) disorders” and she observed that preceding maternal anxiety (even before pregnancy) predicts both excessive infant crying and maternal postpartum depression. Perhaps the mother’s insomnia associated with caring for an excessively crying or colicky baby and the stress from dealing with inconsolable crying might contribute to or cause maternal postpartum depression. But the trigger was preexisting or pre-pregnancy anxiety. For example, an anxious parent told me, “I was so worried that every time he made a sound at night, I rushed in to awaken him to make sure he was all right.” Dr. Petzoldt also wrote that “infants of mothers with anxiety disorders prior to pregnancy were at higher risk for excessive crying than infants of mothers without any anxiety disorder prior to pregnancy.” Additionally, she speculated that “maternal anxiety might lead to intrusiveness that possibly intensifies infant crying [emphasis added].” Intrusiveness is unnecessary night feedings and attention at night.
In her 2018 review of all the literature, Dr. Petzoldt wrote that the best supported path is that preceding maternal anxiety (even before pregnancy) predicts both subsequent excessive crying and maternal postpartum depression. When infant excessive crying and maternal depression are present simultaneously, “a vicious cycle of poor infant self-regulation [excessive crying] and hampered intuitive parenting [maternal depression] emerges.” In a separate study, she showed that the strongest predictors for excessive infant crying were maternal anxiety disorders and a fussy infant temperament; in contrast, infant sleeping problems were associated with maternal depressive disorders.
Blog Post 98-Do Distressed Mothers Cause Sleep Problems?
Research based on mothers who meet the diagnostic criteria for clinical depression are at a higher risk for having an infant with sleep problems. Additionally, for less affected mothers, there are studies that maternal depressive symptoms are predictive of infant sleep problems or that maternal anxiety symptoms are predictive of infant colic that might lead to both maternal insomnia (and/or depressive symptoms) and infant sleep problems (Blog Posts 40–42 and 45). This might be called the mother-driven pathway. Fathers’ role regarding contributing to the development of colic (Blog Post 97) and infant sleep has received much less attention. Separately, there are studies that biological features within-the-child such as a difficult temperament or infant colic (Blog Posts 46–48 and 43, 44 respectively) lead to sleep problems directly or trigger behaviors in the mother that lead to sleep problems. This might be called the infant-driven pathway.
The Mother-Driven-Pathway?
In 2021, Professor Tikotzky published a study designed to answer the question: Do distressed mothers cause sleep problems in their infant? There were 226 upper-middle-class families who were studied during the third trimester of pregnancy and at 3, 6, 12, and 18 months after the birth of their first child. The children were all full-term and there were no medical problems involving the mother or the infant. All the mothers had mild to moderate emotional distress. There findings might not be generalizable to other populations such as families with multiple children, low socioeconomic level, or low parent/social support and “are not relevant to mothers who experience significant distress or major clinical depression.”
Their results “do not support the assumption that changes over time (from pregnancy to 18 months) in maternal emotional distress symptoms predict changes over time (3 to 18 months) in infant objective [actigraphy] and subjective [parent diaries] sleep.”
“Moreover, our findings may tentatively suggest that mothers from middle to upper socioeconomic status who experience moderate distress could be reassured that their symptoms will probably not have an influence on their infants’ sleep quality and duration. We believe that attributing inflated impact to maternal depressive and anxiety symptoms on infant sleep development may unnecessarily undermine new mothers who, in addition to the difficulties arising with the transition to parenthood, cope with emotional distress symptoms. In terms of clinical implications, the findings suggest that an important focus of clinical work with emotionally distressed mothers seems to be adjusting and modifying their sleep-related cognitions and interpretations, rather than focusing on changing the sleep of their infant.”
