Sleep Interventions for Caregivers and Their Young Children in Part C Programs

The caregivers of children with developmental disabilities may have their sleep disrupted by their children’s poor sleep and they may have sleep issues independent of their children that affect their sleep quality and sleep quantity. This research was a mixed method observational study utilizing repeated measures with concurrent caregiver interviews. This project addressed the feasibility and acceptability of a sleep health education intervention for caregivers of children ages birth to 3 years old with developmental disabilities on the Arizona Navajo Nation. It was hypothesized that caregiver education and a tailored intervention that addressed the sleep problems of children with developmental disabilities and their caregivers would improve child and caregiver sleep quality, as well as caregiver quality of life. Fifteen caregivers who had children enrolled in the Part C IDEA early intervention program entitled Growing in Beauty program participated in three 1 hour home-based sessions over a three-month period. The effects of this intervention on caregiver and child sleep quality and quantity and on caregiver health-related quality of life were assessed using standardized pre- and post-test measures (i.e., Medical Outcomes Study-Short Form-12, Sleep Habits Questionnaire, Brief Infant Sleep Questionnaire, Children’s Sleep Habits Questionnaire) in addition to sleep diaries. Interviews and texting provided qualitative data regarding the helpfulness and value of the strategies that were attempted. Pre/post-tests evaluated the changes in their knowledge of sleep health.

Two educational modules were presented that addressed the following topics: sleep health including adequate sleep duration and common sleep problems; strategies for promoting sleep, including daytime habits; bedtime routines; specific strategies for insomnia; preventing drowsy driving; and sleep considerations for caregivers. This home-based intervention included evidence-based and evidence-informed practices for the sleep problems of children and adults. This intervention was tailored to the specific physical and behavioral issues of the child, the sleep needs of the primary caregiver, and the environmental and cultural features of families.

This intervention study used a T-test for statistical analysis of the repeated measures to determine if there are significant differences within subjects pre-intervention and post-intervention. Qualitative data from the sleep diary and interviews were coded to reflect sleep disruptors and beliefs related to sleep health and to identify common themes within and between cases. Following this intervention, many participants reported an increase in the number of hours of sleep per night and a decrease in their insomnia symptoms. Reported health-related quality of life also improved in many participants. Additionally, participants indicated that family and caregiving responsibilities, housing circumstances, and attendance at community events all affected their sleep duration. Participants reported overall satisfaction with this intervention and many stated that they gained an understanding of the importance of sleep for themselves and their children.

This proposed project is unique in its extension of early intervention to address the sleep problems of both children with developmental disabilities and their caregivers. Information gleaned through interviews with participants suggest a need for further research to examine the mechanisms that contribute to poor sleep in Navajo individuals living in a rural location. The educational materials developed for this sleep health intervention will continue to be developed to be used by other health and educational programs on the Navajo Nation and in other rural areas.

References

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