Infant sleep problems: The sleep characteristics of the "Don't Know" response.

Aims: To examine the sleep characteristics of infants with parentally reported sleep problems, with parentally reported no sleep problems and with parentally reported uncertain sleep conditions.

Background: Infant sleep problems are recognized as a major health issue worldwide. However, in our daily clinical practices, it is not uncommon for parents not to know whether their infant sleep is problematic.

Design And Methods: A prospective study conducted between 2012 - 2015 where 219 parents completed questionnaires and infants wore an actigraph monitor for 7 days. Multinomial logistic regression models were used to evaluate the actigraphic and parentally reported infant sleep behaviours between the groups.

Results: Thirty-two (14.61%) parents did not know whether their infant sleep was problematic and 118 (53.88%) parents considered their infant sleep a problem. Compared with infants without sleep problems, infants with uncertain sleep conditions had significantly increased odds of having shortened longest sleep duration according to parental report. A significant association was found for infants without sleep problems compared with those with sleep problems who had significantly more wake after sleep onset as measured by actigraphy, as well as reduced longest sleep duration according to parental report.

Conclusion: Infants with uncertain sleep conditions have the same problematic sleep behaviours resembling those of children with reported sleep problems. Healthcare professionals should actively disseminate sleep knowledge to help parents interpret infant sleep behaviours and consider possible intervention strategies for improving parental sleep-related knowledge and infant sleep.