Mother-Infant Room-Sharing and Sleep Outcomes in the INSIGHT Study

Abstract

Objectives: The American Academy of Pediatrics recommends infant-parent room-sharing until age 1. We assessed the association between room-sharing and sleep outcomes.

Methods: The Intervention Nurses Start Infants Growing on Healthy Trajectories study is an obesity prevention trial comparing a responsive parenting intervention with a safety control among primiparous mother-infant dyads. Mothers completed the Brief Infant Sleep Questionnaire at 4, 9, 12, and 30 months. Reported sleep duration and overnight behaviors, adjusted for intervention group, were compared among early independent sleepers (own room <4 months), later independent sleepers (own room between 4 and 9 months), and room-sharers at 9 months.

Results: At 4 months, reported overnight sleep duration was similar between groups, but compared with room-sharers, early independent sleepers had better sleep consolidation (longest stretch: 46 more minutes, P = .02). At 9 months, early independent sleepers slept 40 more minutes nightly than room-sharers and 26 more minutes than later independent sleepers (P = .008). The longest stretch for early independent sleepers was 100 and 45 minutes more than room-sharers and later independent sleepers, respectively (P = .01). At 30 months, infants sleeping independently by 9 months slept >45 more minutes nightly than those room-sharing at 9 months (P = .004). Room-sharers had 4 times the odds of transitioning to bed-sharing overnight at both 4 and 9 months (P < .01 for both).

Conclusions: Room-sharing at ages 4 and 9 months is associated with less nighttime sleep in both the short and long-term, reduced sleep consolidation, and unsafe sleep practices previously associated with sleep-related death.

FIGURE 1

Room-sharing group and nighttime sleep duration at 4, 9, 12, and 30 months of age. * P < .01.