There have been multiple important publications in the past few weeks which are pertinent to my patients. I’m really excited today to share the results of the Kids Sleep Study which was recently published in the journal Pediatrics and received a significant amount of press. This study was designed to address persistent concerns that sleep training may cause psychological damage to children.
The authors of this study were following up a prior study recruited a large number of families in Australian who had infants under six months of age. Families reporting a problem with their infant’s sleep were offered participating in the study. Half of the families were randomly offered either sleep training or standard care. I love the summary of the sleep training techniques taught which is incredibly succinct:
Two main sleep techniques were offered: 1) “controlled comforting” in which parents respond to their infant’s cry at increasing time intervals to allow the child to self-settle, and 2) “camping out,” in which the parent sits with the child as they learn to independently fall asleep, slowly removing their presence from the child’s room.
The original study showed persistent improved sleep in the children who had received intervention, and decreased symptoms of depression in their mothers when they were age two. The current study followed up the children and families at age six. There are several pertinent findings:
- There was no evidence that children who had sleep training in infancy had more emotional or behavioral problems in the children who were not.
- There was no difference in the stress response (measured by cortisol) in the two groups. (For a good summary of the significance of this, read this article at Science of Mom.)
- There was no benefit to sleep training at six years of age either.
These are tremendously important findings. First of all, parents should not feel guilty about sleep training their child as there are clear short and medium term benefits, and there is no significant risk of harm. Second, children who were not sleep trained did not seem to be suffering in any emotional or sleep related domains. So if you cannot sleep train your child, for whatever reason, that is OK as well.
There are some limitations to this study. Only children sleep trained in the first year of life were included, and they excluded children with significant intellectual disability or developmental delay, so it is difficult to extrapolate the results to other groups. However, as the authors point out, it is unlikely that larger or longer term studies of sleep training will be conducted, as sleep training is now the standard of care due to the strong evidence for efficacy and benefits (see Practice Parameters for Behavioral Treatment of Bedtime Problems and Night Wakings in Infants and Young Children for more info).
I wonder if this makes any parents out there feel better. Let me know.