Investigating sleep interactions in parent-child dyads: a multimethod approach

Sleep is a fundamental biological process with far-ranging consequences for mood, cognition, physical and mental health. It is also a social process that plays a pivotal role in family functioning. Despite this, we do not fully understand the dynamics between a parent and their child's sleep. Hence, this thesis investigated the links between children's sleep disturbances and parents¿ sleep by systematically reviewing previous literature, using parent-reports and collecting actigraphy derived sleep profiles. Feasibility of a self-help sleep intervention tool for parents was also examined.<br><br> The first study involved a systematic review of sleep associations in parents-child dyads. Results from 29 studies revealed significant associations between parent-child sleep quality, sleep duration and sleep efficiency. Parents of children with neurodevelopmental disorders reported poor sleep and high stress. Family characteristics affecting sleep in this dyad and directions for future research were examined.<br><br>   The second study examined multiple sleep outcomes in parents of children with sleep disturbances. A total of 293 parents completed an online questionnaire assessing sleep in parents and their children. Results from the self-reporting study revealed that parents of children with sleep disturbances had poor sleep, poor mood and increased arousal before sleep, which indicated chronic insomnia. Children's sleep mediated the relationship between parents' sleep and mood.<br><br> The third study employed actigraphy to explore temporal associations between sleep and wake in parent-child dyads. It also assessed whether parent-reports of their child's sleep was corroborated by actigraphy. Parents were three times more likely to wake up when their children experienced sustained night-waking in comparison to children waking up when their parents experienced a sustained night-waking. Parent-report of their child's sleep disturbance was also confirmed by actigraphy. Parents of children with sleep disturbances had increased duration of night-wakings as measured by actigraphy and greater sleep variability than parents of children with no sleep disturbances. <br><br> Finally study four pilot-tested the feasibility of a self-help mindfulness tool on sleep and mood in parents. Parents of children with sleep difficulties used a mindfulness app for six-weeks with a baseline and follow-up. The study indicated improvements in parents'  self-reported sleep quality, insomnia symptoms, pre-sleep arousal and sleep onset latency. These results should be validated further in larger samples using more rigorous methods. <br><br> This thesis presents compelling evidence for considering sleep disturbances at a family level, rather than the parent or child alone. Using novel analysis, it illustrates how children's sleep disturbances are associated with increased night-wakings and poorer sleep in their parents. Targeting sleep at a family level can, therefore, improve broader family outcomes. It also demonstrates the potential utility of self-help interventions for parents with sleep difficulties and recommends further testing of self-help sleep interventions.