Abstract：
Methods to improve sleep in infants commonly involve some ignoring (extinction) but are often unpopular with mothers worried about infant distress when left to cry. Alternative more responsive methods are needed. This pilot study evaluated stress, maternal depressive symptomology and sleep in mother/infant dyads, between Responsive, Controlled Crying and Control groups. From 199 mother/infant dyads from any cultural background, 41 infants 4-12 months were randomly allocated to Responsive (RG, n = 15), Controlled Crying (CCG, n = 18) or Controls (Treatment as Usual, TAUG, n = 8), with 10 withdrawing after randomisation. Infant sleep (7-day sleep diaries) and stress (oral cortisol on two nights), maternal self-reported stress (Subjective Units of Distress, SUDS), maternal perceived infant distress (MPI-S) and symptoms of maternal depression (Edinburgh Post-natal Depression Scale, EPDS) were measured four times across 8 weeks. Sleep duration was not different between groups but Responsive woke less (p = .008). There were no differences in cortisol between groups across time points. Maternal SUDS was positively correlated with infant cortisol and MPI-S (p < 0.05) and mothers in the Responsive group were significantly less stressed (p = 0.02) and reported less symptoms of depression (p < 0.05). Findings in this small sample show Responsive methods are comparable to the extinction (Controlled Crying) in sleep outcomes but from a relational and maternal mental health perspective, are less stressful, offering families potential choices of sleep interventions.
摘要：
改善婴儿睡眠的方法通常涉及一些忽略（灭绝），但通常不受担心婴儿哭泣时困扰的母亲的欢迎。需要替代的反应更灵敏的方法。这项试点研究评估了压力，母亲/婴儿二元组的母亲抑郁症状和睡眠，在响应性之间，控制组和控制组。来自任何文化背景的199个母亲/婴儿双子，41名4-12个月的婴儿被随机分配到Responsive(RG，n=15),受控哭泣(CCG，n=18)或对照(照常治疗，TAUG,n=8),随机分组后退出10个。婴儿睡眠（7天睡眠日记）和压力（两晚口服皮质醇），母亲自我报告的压力(主观痛苦单位，SUDS),产妇感知婴儿窘迫(MPI-S)和产妇抑郁症状(爱丁堡产后抑郁量表，EPDS）在8周内被测量四次。两组之间的睡眠时间没有差异，但响应性觉醒较少（p=.008）。各组之间的皮质醇在时间点之间没有差异。母亲SUDS与婴儿皮质醇和MPI-S呈正相关（p<0.05），响应组的母亲压力明显减轻（p=0.02），抑郁症状较少（p<0.05）。在这个小样本中的研究结果表明，反应性方法与睡眠结果的灭绝（受控哭泣）相当，但从关系和母亲心理健康的角度来看，压力较小，为家庭提供睡眠干预的潜在选择。
