[Impact of parenting behavior relevant to infant's sleep on maternal sleep and health].

Background: Maternal health is affected by infant's sleep problems like night awakening or bedtime difficulties. Previous studies indicated that infant's sleep problems are affected by particular parenting behaviour (hereinafter referred to as parenting). However, the relation between maternal sleep and infant's sleep has been unclear and there is only limited information on the interaction between parenting, infant's sleep, maternal sleep, and maternal health. The purpose of this study was: 1. to examine the relationship between infant's sleep problems and maternal sleep and health; and 2. to investigate comprehensive relations of four parameters; maternal sleep, maternal health, infant's sleep, and parenting.

Methods: The subjects were 194 mothers who attended health checkup for 4month old infants. The questionnaire consisted of 3 components: 1) infant's and mother's sleep habits and sleep problems; 2) maternal health; 3) parenting. There were 15 items for parenting, divided into desirable and undesirable behavior. Subjects were classified into Problem Group (n = 40) or Control Group (n = 142) according to the infants' sleep problems. Maternal sleep, maternal health, parenting were compared between two groups. In addition, we examined relationships among the four parameters using path analysis.

Results: Over 60% of mothers experienced some sleep problems and about 30% were suspected of being at high risk of insomnia. The most common mother's sleep problem was "poor sleep quality". Over 80% of mothers had some health problems, that most frequently observed being "Shoulder stiffness". Desirable parenting like "Feed fully and checking the diaper before bedtime" was observed in 80% of mothers, while undesirable parenting like "Feeding or checking a diaper immediately" was seen in 71% of mothers. Maternal sleep problems, maternal health problems, and undesirable parenting were more frequent in the Problem Group than the Control Group. As a result of path analysis, the following relations were found: undesirable parenting affected infant's sleep problems, infant's sleep problems influenced maternal sleep, and mother's sleep influenced maternal health.

Conclusions: Thirty percent of mothers were suspected of having sleep disorder and more than half practiced undesirable parenting. Undesirable parenting affected infant's sleep problems which in turn directly affected mothers' sleep and indirectly affected mother's health.