Sleep tips and supports from specially-trained nurses are valued by new parents but do not help increase postpartum sleep for first-time moms or their babies. According to a new study by Dr. Robyn Stremler, assistant professor at the Lawrence S. Bloomberg Faculty of Nursing, participants who received the sleep intervention program, including in-hospital sessions and telephone support, and those that did not recorded the same amount of postpartum sleep.
This study, published online in the BMJ (British Medical Journal), studied sleep patterns of 246 new moms in Ontario and their infants at six and 12 weeks old.
"Moms are always looking for solutions to get more sleep for themselves and their babies and the idea behind this program was to incorporate delivery of strategies to promote sleep into postpartum care," says Stremler "Postpartum sleep is complex and these findings suggest that first-time moms have so much to learn with their baby in the first few weeks that fostering maternal and infant sleep patterns may be difficult to do. Health care practitioners want to provide effective interventions to help parents reduce sleep deprivation and fatigue and this study takes us in the right direction."
• First large-scale trial aimed at improving both maternal and infant sleep to use actigraphy, a noninvasive method of data collection that objectively monitors human rest and activity cycles;
• Participants reported using many of the suggested strategies to improve sleep and they enjoyed receiving the information from the sleep intervention nurses;
• Moms in the sleep intervention group, who received the additional nursing support, and the usual care group both averaged 6.5 hours of nighttime sleep;
• Delivering sleep interventions at the early postpartum stage in-hospital and in the first weeks at home is ineffective in improving maternal and infant sleep, so interventions may be better targeted after the first few months postpartum; and
• There was no effect of the sleep intervention program on maternal depressive symptoms, fatigue or breastfeeding rates.
First-time moms were randomised into two groups immediately following birth and followed over 12 weeks. The first group had in-hospital sessions with a sleep intervention nurse for 45-60 minutes, nursing follow-up support with phone calls at one, two and four weeks and were given a self-learning booklet on sleep tips. The second group had access to standard postpartum care in hospital. Then, when the baby was 6 and 12 weeks old, for four consecutive days and nights, participating moms wore an actigraph around the wrist and infants wore them around the ankle. These devices detected and recorded movement across one-minute intervals which were then translated by a computer algorithm into sleep and wake times.
The multisite randomised controlled trial was the first to use actigraphy to measure maternal and infant sleep outcomes and the first to have an intervention that focused on new moms and their babies, rather than just infant sleep. Traditionally, intervention studies have relied on parental reporting of infant sleep which, for a multitude of reasons such as parent fatigue, might not always be accurate. Using actigraphy for reporting meant data was as accurate and objective as possible.
The full study titled Effect of a behavioural-educational intervention on sleep in primiparous women and their infants in early postpartum: multisite randomised controlled trial is available online at the British Medical Journal.
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