Infant and Toddler Sleep: The Existing Knowledge Gaps!

Abstract Background: Sleep architecture of infants is vastly different from adults and a significant knowledge gap exists in understanding infant sleep. We aimed to study infant sleep behavior by using validated revised Brief Infant Sleep questionnaire at a tertiary care center in Western Maharashtra. Methodology: We enrolled 65 infants from 1 month to 3 years of age visiting Pediatric OPD between October 2023 to March 2024. We aimed to study infant sleep behavior in a cross section of population at a tertiary care center with a view to find out prevalence of behavioral insomnia of childhood in study population. Results: Around 38.5% children were sleeping less than 5 hours at night and 12.3 % were sleeping only for 6-7 hours. 58.5% children had prolonged sleep onset latency between 30-60 minutes. Around 27.7% children had sleep latency even more than 60 minutes after being put to bed. 70.8% children reported nocturnal awakenings of whom 18.3% reported frequent awakenings. Total sleep duration in our study was 8.592 ± 1.79 hours (Mean ± 2SD). Longest stretch of nocturnal sleep was 5.869 ± 3.72 hours (Mean ± 2SD). Based on the total duration of sleep, prevalence of behavioural insomnia of childhood in our study was 41.5%. The most common associations with behavioural insomnia of childhood were breastfeeding, bottle feeding and rocking but the results were not statistically significant. Conclusion: Prevalence of behavioral insomnia of childhood in India is higher than western population. Indian children have shorter average sleep duration compared to their western counterparts. Bedtime routine needs to be observed regularly to avoid development of behavioral insomnia of childhood which requires strict bedtime rules and consistency.