The association between infant sleep, cognitive, and psychomotor development: A systematic review

Abstract

Study Objectives: To synthesize findings of original articles examining the association between sleep-wake patterns of typically developing infants aged 0 to 18 months and cognitive and psychomotor development. Methods: A systematic search strategy was used to identify articles assessing the association between infant sleep (0 to 18 months) and cognitive/psychomotor development (Medline, PsycINFO, and SCOPUS). Of 7136 articles screened, 22 articles met inclusion criteria, and the results were subsequently synthesized. A quality assessment was conducted, and studies were categorized as "poor,""fair,"or "good."Results: Out of 22 studies, 2 found exclusively significant associations (SAs) between infant sleep and cognitive/psychomotor development, 2 found no SAs and 17 found mixed results (MRs). Studies with exclusively significant results used a single sleep variable and single timepoint designs. Studies finding MRs or no SAs used multiple sleep, developmental variables, or multi-timepoint designs. Eight out of 10 studies and 7 out of 8 studies investigating nocturnal and total sleep duration, respectively, found no SA with developmental outcomes. While 63% of studies were rated as having good methodological quality, all studies but one had an estimated power of less than 0.80. Conclusions: Findings of this review do not support conclusive associations between sleep-wake patterns in infancy and cognitive/psychomotor development. This conclusion contrasts with the literature in older populations, questioning if the association between sleep and development is of a different nature in infancy, potentially because of brain maturation. More studies including larger samples will be needed to clarify the presence or absence of such an association.