A Healthy Child Needs a Healthy Brain, A Healthy Brain Needs Healthy Sleep

4. At bedtimes, do you leave the room after soothing or stay until your child is in a deep sleep state? Leaving the room after soothing predicts better sleep for your child (Blog Post 77).

A study by Professor Mindell noted that parental presence at sleep onset is much more common in Asian than English-speaking countries. “Parental presence in the room at bedtime was the most potent predictor in explaining the number of night wakings, longest sleep interval, and total sleep time.” Separately, in another study of 3-year-olds, shorter night sleep duration was linked to parental presence when falling asleep. A third study noted that parental presence until sleep onset was the factor most strongly associated with night awakening at 17 and 29 months.

A 2020 research paper, by Dr. Jacqueline Henderson, prospectively studied parental presence at sleep onset in a group of children at 1, 3, 6, 9, and 12 months of age, using a 6-day sleep diary. At 6 and 12 months, some infants were classified as “self-sleep regulated (S-R) and some as non-self-sleep regulated (NS-R).  The “self-sleep regulated (S-R) infants had earlier bedtimes, longer night sleep, fewer night wakings per night, fewer night wakings per week, less time awake per night waking, less bed-sharing (co-sleeping).”  Also, parental presence at sleep onset at 1 month predicted S-R and NS-R status at 6 and 12 months.  

5. Are you emotionally available (EA) at bedtime and during the day?  More EA predicts better sleep for your child (Blog Posts 17 and 57).

One study described Emotional Availability (EA) of the mother at bedtime as follows:

• Sensitivity: Rated high when the mother detected immediately, interpreted accurately, and responded promptly and appropriately to the infant’s signals by fulfilling the infant’s needs such as feeding, soothing, and diaper changing.
  
• Structuring:  Rated high when the mother engaged with the infant in bedtime routines in a quiet, soothing, and organized manner that gently induced the infant to sleep.
  
• Nonintrusiveness:  Rated high when the mother did not initiate arousing activities with the baby or other family members.
  
• Nonhostility:  Rated high when the mother did not display covert or overt impatience, frustration, or anger at bedtime.

When mothers were more emotionally available. The infants slept more throughout the night. Mothers who were ranked high on EA had infants with lower bedtime and nighttime cortisol (indicating less stress) compared to infants whose mothers ranked low on EA.

A new, 2021, research paper by Professor Bror Ranum, titled “Persistent Short Sleep from Childhood to Adolescence: Child, Parent, and Peer Predictors” studied EA during the day, not at bedtime.  

They refer to Parental Emotional Availability as “the ability of parents to demonstrate warmth, consistency, understanding, and positive communication. Typically, parents are children’s most salient and important regulatory scaffold and thus constitute the environmental factor which impacts children’s sleep the most.” They described parental emotional availability as follows:

1. Sensitivity: Parent’s ability to develop and maintain a positive and healthy emotional connection with the child-promoting engaging, joyous, and creative play.
2. Structuring: Parent’s contribution in structuring activities and how effectively the parent limit unwanted behavior in the child that may reduce the emotional connection.
3. Nonintrusiveness: Parent’s ability to facilitate child autonomy by not taking too much control, helping too much, or overprotecting the child.
4. Nonhostility: Not displaying behavior that can be frightening or threatening to the child -such as showing dissatisfaction, impatience, boredom, anger, or raising one’s voice.

They studied 800 children and made assessments every 2 years between 6 and 14 years. Sleep duration was measured objectively with hip-strapped monitors and Parent Emotional Availability was measured by coding video recordings of parents (82% mothers) and children during 4 consecutive structured sequences: free play, child led play, parent led play, and a clean-up task. Also, they defined ‘Temperamental Negative Affectivity’ as the tendency to experience negative emotions (sadness, fear, anger, and discomfort) more often, more intensely, and for a longer duration than others.  

Conclusion: They identified a subgroup of children (20%) as having persistent short sleep between 6-14 years of age and “Temperament negative affectivity. Low parental emotional availability predicted membership to that group.”