Efficacy of an internet-based intervention for infant and toddler sleep disturbances

Objective: Sleep problems occur in 20% to 30% of young children. Although behaviorally based interventions are highly efficacious, most existing interventions require personal contact with a trained professional, and unfortunately many children remain untreated. However, the use of an internet-based intervention could provide widespread access. Thus, the purpose of this study was to examine the efficacy of an internet-based intervention for infant and toddler sleep disturbances, as well as to assess any indirect benefits to maternal sleep, mood, and confidence. Methods: 264 mothers and their infant or toddler (ages 6-36 months) participated in a 3-week study. Families were randomly assigned to one of 2 intervention groups (algorithmic internet-based intervention alone or in combination with a prescribed bedtime routine) or a control group. After a one-week baseline (usual routine), the intervention groups followed personalized recommendations during weeks 2 and 3. All mothers completed the Brief Infant Sleep Questionnaire, the Pittsburgh Sleep Quality Index, and the Profile of Mood States weekly. Results: Both internet-based interventions resulted in significant reductions in problematic sleep behaviors. Significant improvements were seen in latency to sleep onset and in number/duration of night wakings, P < 0.001. Sleep continuity increased as well as mothers' confidence in managing their child's sleep. Improvements were seen by one week, with additional benefits by week two. Maternal sleep and mood were also significantly improved. Conclusions: This internet-based intervention (with and without routine) is beneficial in improving multiple aspects of infant and toddler sleep, especially wakefulness after sleep onset and sleep continuity, as well as improving maternal sleep and mood.