Comparison of behavioural sleep interventions to reduce infant sleep disturbances and improve parental mental health

At the first intervention session (compulsory initial two hour session) parents (in both intervention conditions) will receive informational material, including a booklet of information about normal infant sleep patterns, sleep cycles and the potential for an infant to wake overnight several times. A flowchart on how to undertake each sleep intervention will also be provided to each participant. Benefits of an infant learning to fall asleep independently, parental dependence and learning theory will be discussed. Trainers will teach parents a step-by-step guide of how to reduce infant dependence on parental settling based on the principles of their specific intervention. Trainers will also teach parents to identify problems with implementation and compliance of the intervention. Barriers to success, such as attitudes, crying thresholds, parenting confidence, social support and parenting styles will be discussed. The booklets and flowcharts that will be given out to parents have all been previously utilized in clinical settings. The controlled crying information has been taken from the Raising Children Network website. The Responsive intervention information has been taken from The "Paediatric Sleep Clinic" in Adelaide that specialise in delivering this intervention. The controlled crying intervention will be delivered by a nurse who has been trained in the intervention by published experts in this field. This intervention will entail the following; parents will be asked to put their infant into bed (while still awake) and leave their infant alone and ignore any cries of protest for progressively increasing periods of time (for example, a parent will only return to their infant after waiting increasing intervals at their discretion such as 2, 4, 6, 8, 15 minutes, each night). Parents will then attend to their child quickly and quietly until leaving again for a longer period. The responsive intervention method will be presented by an experienced and published clinical psychologist with over 10 years’ experience in delivering sleep interventions. This intervention will entail the following; parents will be asked to put their infant into bed (while still awake) instead of ignoring the infant for the allocated 2, 4, 6 minutes and leaving the room, parents will stay in the room and respond to the child as much as the parent pleases, but reduce the frequency and intensity of the interaction (at parental discretion) with them so that dependency on parental assistance is gradually reduced. The mode of delivery for these sessions is face-to-face group sessions. The initial two hour session is compulsory and will be held in this format. The additional follow-up sessions are optional and if parents are unable to attend the face-to-face session, a phone call session will be held instead. The purpose of these two follow-up sessions/phone calls are to trouble shoot any issues that parents may behaving with the interventions, as well as complete follow up measures of our outcome variables (infant sleep, parental depression, sense of competency etc) Adherence to the program will be assessed subjectively using a compliance scale ranging from "complied with the program 100%" to "did not comply with the program at all". To maintain adherence parents will be reminded about the importance of compliance with the program. Compliance measures will be taken at multiple time points throughout the interventions (i.e. at the beginning of the intervention, 2 weeks post, and 4 weeks post intervention). This will allow us to determine if parents are complying with the program and to follow-up with those that are not to see if they need further assistance with the program. There will be 3 sessions per condition. The first session is a 2-hour compulsory training. The following two are dependent on parental availability, and will only be 1 hour long. These sessions will be held every two weeks over the period of a two months. Follow up phone calls will also be made at 3 and 4 months post intervention delivery. The location of the intervention will be in a workshop room at Central Queensland University at the Appleton Institute, in Adelaide, South Australia.