The relationship between the presence of parental sleep quality, fatigue, anxiety and depression and infant sleep quality and sleep characteristics in paediatric health follow-up

Introduction: Sleep is also an active process necessary for the growth and development of infants and children. Healthy sleep for babies ensures that their cognitive and psychomotor development and growth are at an optimal level. Baby's sleep quality and sleep patterns do not only affect the baby, but they also significantly affect the caregivers' (mother, father, caregiver) sleep patterns, stress, fatigue and mental health. For the baby to grow up healthily and for the parents to be at their best mentally and physically, the baby's sleep quality should be good. When the literature is examined, sleep problems and night awakenings in infancy, early childhood and preschool period are observed at a rate of about 20-30%. The majority of studies evaluating the effects of infant sleep quality on parents have been conducted with mothers, with only a few studies in recent years evaluating the effects on fathers. Objective: This study aims to determine the relationship between maternal and paternal sociodemographic characteristics, sleep quality, fatigue, anxiety, and depression in 6-12 month-old infants whose parents applied to Ankara University Division of Social Pediatrics Child Health Monitoring Outpatient Clinic and who underwent routine child health follow-up. Material and Method: The study included 83 infants aged 6-12 months and their parents who applied to the Ankara University Faculty of Medicine, Department of Pediatrics Department of Pediatrics, Division of Social Pediatrics, Child Health Monitoring Outpatient Clinic and underwent routine child health follow-up. Sociodemographic data collection questionnaire, Brief Infant Sleep Questionnaire (BISQ), Pittsburgh Sleep Quality Index (PSQI), Generalized Anxiety Disorder-7 Test (GAD-7), Edinburgh Postpartum Depression Scale (EPSDS) and Multidimensional Assessment of Fatigue Scale were used to collect data. Descriptive statistics and regression analysis were performed using the SPSS (Statistical Package for Social Sciences; SPSS Inc., Chicago, IL) 22 package program. The statistical significance level was taken as 0.05. Results: The babies' mean age was 8.66±2.30 months, and the median age was 9 months, with a minimum of 6 and a maximum of 12 months. The total daily sleep duration of the children who participated in our study was 11.24 hours on average according to the answers given by the mothers and 11.55 hours on average according to the answers given by the fathers. It was determined that the majority of the babies (79.5% in the answers given by mothers and 79.3% in the answers given by fathers) slept in the same room with their parents. In our study, it was found that babies mostly fell asleep while being breastfed, rocked or held on the lap. When the BISQ questionnaire responses were examined, it was found that 28.9% of the babies according to mothers and 25% of the babies according to fathers were poor sleepers. However, 57.3% (n: 47) of the mothers and 52.4% (n: 43) of the fathers who participated in the study perceived their infants' sleep as problematic. When the answers given to the BISQ were analyzed, no significant difference was found between poor sleepers and non-poor sleepers in terms of parental age, number of people living at home, parental education level, parental employment status, number of children living at home, home type and family type according to the answers given by the mothers and fathers. (p>0.05). No significant difference was found (p>0.05) between the perception of problematic and unproblematic sleep of the infant according to the perception of the mother and father in terms of the infants' age, sex, mode of delivery, the mothers' and fathers' age, father's employment status, number of people living at home, number of children living at home, and family type. However, there were statistically significant differences in the mothers' employment status (p=0.004), mother's educational level (p=0.01), and fathers' educational level (p=0.03). There was a statistically significant difference in the presence of depression in the mother between cases of problematic and non-problematic sleep of the baby, according to the mother's perception (p=0.030). The Univariate Logistic Regression Analysis revealed that the mothers' employment status and the presence of depression in the mother were found to be predictors of sleep problems in the infant according to the perception of the mother. According to multivariate regression analysis, mothers' employment status and maternal sleep quality were found to be predictors of infant sleep problems. According to univariate logistic regression analysis, the fathers' bachelor's degrees or higher educational degrees were found to be a predictor of the likelihood of perceived sleep problems. Discussion and Conclusion: This study revealed that parents' perceptions of their infants' sleep quality were similar. In our study, unlike previous studies, the relationship of both mothers' and fathers' sleep quality, fatigue, anxiety and depression with infant sleep quality and sleep characteristics were examined together. The finding of maternal depression as a determinant for sleep problems in the infant shows the importance of supporting mothers in the postpartum period and providing sleep education to parents about their infants. In our study, the finding that the father's education level of university and above was found to be a predictor of the likelihood of sleep problems perceived by the father in the infant may indicate that fathers also play a role in infant care and perceive problems related to their infants more as the level of education increases. Today, the involvement of fathers in infant care has increased, and studies that will include both mothers and fathers and examine the relationship between parental characteristics and infant sleep and increase the number of cases will strengthen the data in the literature. Key words: Brief Infant Sleep Questionnaire, Postpartum Depression, Postpartum Anxiety, Mother, Father