0399 The Effects Of CBTI+TIPS On Maternal Cognitions About Infant Sleep And Infant Nighttime Sleep Duration

Abstract

Introduction: Prior studies have found that parental concerns about limiting their nighttime involvement are associated with poorer infant sleep quality. We examined maternal cognitions about infant sleep in relation to their infants' sleep and maternal insomnia. Methods: The sample consisted of 105 women in a randomized controlled trial for perinatal insomnia. They were randomized to cognitive‐behavioral therapy for insomnia plus tips for infant sleep (CBTI+TIPS) or an active control insomnia therapy plus general education about infant sleep (CTRL). Treatment consisted of five weekly sessions during pregnancy and a sixth session at six weeks postpartum. Mothers completed the Infant Sleep Vignettes Interpretation Scale (ISVIS) that assesses parental sleep‐related cognitions at 5 weeks postpartum, the Brief Infant Sleep Questionnaire (BISQ) at 30 weeks postpartum, and the Insomnia Severity Index (ISI) at both time points. Results: Mothers in the CBTI+TIPS arm scored lower on the Distress subscale (p=.028) and higher on the Limits subscale (p=.049) of the ISVIS than mothers in the CTRL arm. In the whole sample, after adjusting for treatment, maternal depressive symptoms, insomnia severity, and nulliparous stats, regression analysis revealed that lower ISVIS‐Distress scores at 5 weeks postpartum predicted longer duration of infant's nighttime sleep at 30 weeks postpartum (N=72, beta=‐.316, p=.003). Mothers with scores below the median (3.71) on the ISVIS‐Distress subscale reported their infants slept 36 minutes longer at night (602 vs. 566 minutes) at 30 weeks. However, ISVIS scores at 5 weeks postpartum did not predict maternal insomnia severity at 30 weeks postpartum. Conclusion: Mothers who had insomnia during pregnancy benefited from CBTI+TIPS by learning tools for setting the stage for healthy infant sleep development. They were less likely to interpret infant night‐wakings as a sign of distress and more likely to emphasize the importance of limiting parental nighttime involvement. It is unclear if these results will generalize to new mothers without prior histories of insomnia. Nonetheless, it appears that having realistic expectations about infant sleep during the early postpartum can translate to longer infant sleep duration later.