Research Shows That Co-Sleeping with Toddlers Can Impact Mother's Mental Health

University of Maryland School of Medicine and School of Nursing Researchers Find Co-Sleeping Increases Stress, Depression and Anxiety for Mothers

BALTIMORE, Md., – For parents of toddlers with sleep problems, co-sleeping may not be a good strategy, according to new research from the University of Maryland School of Medicine (UMSOM) and the University of Maryland School of Nursing (UMSON). Co-sleeping is defined as a parent sleeping in the same room or same bed with their child.

The study, which was published in the Journal of Developmental and Behavioral Pediatrics, involved 277 low-income mothers and children ages 12 to 32 months living in Baltimore. Researchers found that toddlers in low-income families often co-sleep with their parents in the same room or in the same bed. Researchers studied whether co-sleeping affects mothers' sleep and mental health.

The research showed that mothers who co-sleep with toddlers with perceived sleep problems lost almost one hour of sleep and reported symptoms of stress, depression and anxiety. The mothers of children who did not have perceived sleep problems did not lose sleep or have depressive symptoms, regardless of the sleeping arrangement.

"Without enough sleep, parents are likely to feel sleepy and irritable, making it difficult to care for an active toddler," said Maureen M. Black, PhD, the John A. Scholl, MD and Mary Louise Scholl, MD Endowed Professor in Pediatrics at UMSOM and director of the Growth and Nutrition Clinic in the Department of Pediatrics at the University of Maryland Children's Hospital (UMCH). "Mothers who perceive their child as having a sleep problem and then sleep in the same bed or room with the child as a means of comfort are likely to wake up during the night, get less sleep and report symptoms of stress, anxiety and depression. In principle, these results can be extrapolated to any family with a toddler, as a toddler who awakens and looks for a parent disrupts the parent's sleep.";

The study's authors are Lauren B. Covington, MS, RN, a pediatric nurse and UMSON PhD candidate; Bridget Armstrong, PhD, MS, UMSOM postdoctoral fellow; and Dr. Black.

Co-sleeping is a common issue in assessing children's health, particularly during infancy. The American Academy of Pediatrics recommends that parents sleep in the same room with their infants; however, to prevent SIDS, they recommend against sleeping in the same bed. For toddlers, though, there are no sleep guidelines, in spite of the challenges of night awakenings and difficulty going to sleep that are common among this age group as they learn to self-soothe and develop mature sleep patterns.

Parents who co-sleep with their young children often describe disruptions to their sleep as the child awakens or moves around the bed. Many co-sleeping parents express a desire for their child to sleep independently. With that said, family situations often complicate independent sleeping, including limited bed or bedroom space; noise from family activities such as TV or music; and a desire for the child to stay up late because a caregiver works the late shift.

Parents who believe their toddler has a sleep problem should consider looking for an alternative to co-sleeping to help the child learn to self-soothe and go back to sleep without assistance, according to the researchers. A pediatrician can help parents troubleshoot and identify a strategy besides co-sleeping. Pediatricians should be aware of sleep problems in patients and families, as well as how family situations may be contributing.

Adults need between seven and nine hours of sleep per night, according to the National Sleep Foundation. Children need more sleep than adults – toddlers need 11 to 14 hours of sleep per day and preschoolers need 10 to 13 hours.

"This study explores an important yet understudied area of maternal and child health," said Steven J. Czinn, MD, the Drs. Rouben and Violet Jiji Endowed Professor of Pediatrics and chair of the Department of Pediatrics at the University of Maryland School of Medicine and director of the University of Maryland Children's Hospital. "Raising a toddler can be challenging, without the added stress of not getting enough sleep. Pediatricians and family medicine practitioners who are aware of how co-sleeping affects mothers' sleep and mental health, particularly among families with limited space and complex family situations, can help families identify strategies to promote self-soothing and adequate sleep for mothers and their children."

"This study is an outstanding example of how collaboration among the University of Maryland School of Medicine, School of Nursing and Children's Hospital enables us to accelerate our pace of discovery and, together, make real progress in caring for our communities," says UM SOM Dean E. Albert Reece, MD, PhD, MBA, who is also the executive vice president for medical affairs at the University of Maryland and the John Z. and Akiko K. Bowers Distinguished Professor.

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About the University of Maryland School of Medicine

Commemorating its 210^th Anniversary, the University of Maryland School of Medicine was chartered in 1807 and is the first public medical school in the United States. It continues today as an innovative leader in accelerating innovation and discovery in medicine. The School of Medicine is the founding school of the University of Maryland and is an integral part of the 11-campus University System of Maryland. Located on the University of Maryland's Baltimore campus, the School of Medicine works closely with the University of Maryland Medical Center and Medical System to provide a research-intensive, academic and clinically based education. With 43 academic departments, centers and institutes and a faculty of more than 3,000 physicians and research scientists plus more than $400 million in extramural funding, the School is regarded as one of the leading biomedical research institutions in the U.S. with top-tier faculty and programs in cancer, brain science, surgery and transplantation, trauma and emergency medicine, vaccine development and human genomics, among other centers of excellence. The School is not only concerned with the health of the citizens of Maryland and the nation, but also has a global presence, with research and treatment facilities in more than 35 countries around the world. http://medschool.umaryland.edu.

About the University of Maryland Children's Hospital

The University of Maryland Children's Hospital at the University of Maryland Medical Center is recognized throughout Maryland and the mid-Atlantic region as a resource for critically and chronically ill children. UMCH physicians and staff excel in combining state-of-the-art medicine with family-centered care. More than 100 physicians specialize in understanding how to treat conditions and diseases in children, including congenital heart conditions, asthma, epilepsy and gastrointestinal disorders. The Drs. Rouben and Violet Jiji Neonatal Intensive Care Unit (NICU) provides the highest level of care to the tiniest newborns. Learn more about the University of Maryland Children's Hospital.

About the University of Maryland School of Nursing

The University of Maryland School of Nursing, founded in 1889, is one of the oldest and largest nursing schools in the nation and is ranked among the top 10 nursing schools in the United States. Enrolling more than 1,900 students in its baccalaureate, master's, and doctoral programs, the School develops leaders who shape the profession of nursing and impact the health care environment.