Nurturing care for early childhood sleep interventions with tailored care: the NEST Approach

Abstract

Early childhood insomnia (ECI) affects 20-30 % of children aged 6-36 months, making it the most common sleep disturbance in this age group. Current interventions often focus on independent sleep through extinction-based behavioral methods, with less emphasis on broader socioecological influences such as caregiving quality and feeding practices. This paper introduces a conceptual model to reframe ECI interventions using the World Health Organization endorsed Nurturing care framework (NCF), which includes five components: good health, adequate nutrition, safety and security, responsive caregiving and opportunities for learning. Sleep is essential for health, and early childhood represent a critical window for shaping lifelong sleep patterns. Breastfeeding helps integration of all five components while responsive caregiving, supports the other four components. Sensory-motor nourishment fosters a sense of safety and early learning opportunities promote self-regulation. The model outlines actionable strategies under each NCF components, offering guidance for researchers and supporting adaptation across diverse settings, viewing sleep health as part of a broader caregiver ecosystem rather than isolated behavioral problem.

Keywords: Early childhood; Infant; Insomnia; Nurturing care; Sleep.