Night waking in Thai infants at 3 months of age: Association between parental practices and infant sleep

Background and purpose: Night waking is common among infants and can create sleep deficit in both parents and infants. Sleep practices are influenced by cultural variations which may affect the prevalence and associated factors of frequent night waking. Our objective was to determine whether differences in parental practices related to infant sleep are associated with frequent night waking in Thai infants. Methods: A cross-sectional survey based on interviews with parents of infants aged three months, birth weight greater than 2500 g, conducted under the Prospective Cohort study of Thai Children (PCTC). Results: Of the total sample, 82.9% (3172 of 3826) of parents provided completed night waking information. The mean number ( standard deviation [SD]) of awakenings per night was 2.7 +/- 1.1, 47.3% awoke 1-2 times per night, and 46.9% awoke 3-4 times per night. The group of frequent night wakers (more than 14 night wakings per week, n = 1634) was compared with the group of infrequent night wakers (n = 1538). Significant and independent associations were present between frequent night waking and male gender (odds ratio [OR] of 1.5; 95% confidence interval [CI], 1.3-1.8), more than three naps per day (OR, 1.3; CI, 1.1-1.5), use of a swinging or rocking cradle (OR, 1.5; Cl, 1.2-1.98), falling asleep while feeding (OR, 1.3; CI, 1.1-1.5), and breastfeeding only (OR, 1.2; CI, 1.1-1.4). No significant association was noted between frequent night waking and parental age, education, occupation, household income, type of parental response to infant's nighttime crying, or type of diaper. Conclusion: An association with frequent night waking was demonstrated with various factors of parental practice related to infant sleep, such as number of naps, use of a swinging or rocking cradle, breastfeeding only, and falling asleep while feeding. Further documentation of these associations may be clinically important. Implementing preventive interventions may be able to reduce frequent night waking in early infancy. (C) 2007 Elsevier B.V. All rights reserved.