Infant Mental Health for the Pediatric Nurse Practitioner

Sleep


Infant sleep is usually irregular and inconsistent causing concern (and fatigue) for sleep-deprived parents. 

Parents should be advised to encourage infant self-soothing techniques. Usual sleep parameters for infants are as follows:

Usual sleep parameters in the first year of life (Davis, 2004):  ​

Age in months          Night sleep hours          Day sleep hours            Longest sleep period
One month                             8                               7.75                                      2-4
6 months                               10                              4.25                                        6
12 months                           10.25                            3.5                                         X

Night wakening can be especially troublesome. According to Charles H. Zeanah MD: waking during the night is usual for infants age 3-6 months. Approximately 30% of infants are signalers who wake up, cry, and expect someone to comfort them. About 60-70% of 8 month old infants will self-comfort after night waking, and fall back to sleep.

If sleep problems persist to 6-9 months of age, it is important to take a good history focusing on bedtime routines and other factors that may influence sleep: television noise and light, allergies, room temperature. The first step intervention in addressing sleep issues is to set a consistent bedtime and a regular bedtime routine.

It is important to discuss SIDS prevention with all parents of  infants under 12 months of age: http://pediatrics.aappublications.org/content/early/2012/03/21/peds.2011-1419

References and Resources:

Consistent Routine Helps Babies Sleep: http://www.chicagotribune.com/health/ct-x-infant-sleep-environment-20120620,0,1240687.story

Infant Sleep Problems May Persist Into Toddlerhood: http://pediatrics.aappublications.org/content/early/2012/01/02/peds.2011-0372 

National Sleep Foundation:  http://www.sleepfoundation.org/article/sleep-topics/children-and-sleep

The Origins, Prevention and Treatment of Infant Crying and Sleeping Problems: An Evidence-Based Guide for Healthcare Professionals and the Families They Serve: http://www.psychotherapyarena.com/the-origins-prevention-and-treatment-of-infant-crying-and-sleeping-problems-9780415601177

'Child Behavior' Linked to Snoring:  http://www.bbc.co.uk/news/health-17237576

Screening for Sleep Problems in Children: http://www2.aap.org/sections/dbpeds/pdf/PDFNewContent/ScreeningAssess/ScreeningForSleepProblems.pdf

Sleep Log:  http://www2.aap.org/sections/dbpeds/pdf/sleeplog.pdf