Browsing by Author "Keys, Elizabeth"

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    Effectiveness of Play2Sleep with Mothers and Fathers of Infants: A Mixed Methods Study
    (2019-04-25) Keys, Elizabeth; Benzies, Karen Marie; Duffett-Leger, Linda A.; Kirk, Valerie G.
    Infant sleep disturbances distress approximately one in four Canadian families and are associated with poorer parental health, family well-being, and child developmental outcomes. Assisting families to manage infant sleep disturbances may improve well-being, as well as support child development. However, addressing only sleep-related parenting behaviors and interactions may be ineffective in improving broader parenting difficulties that may underlie infant sleep disturbances. Play2Sleep combines personalized infant sleep information with examples from a self-modelled video recorded structured parent-infant play session to provide feedback aimed at enhancing parental ability to identify and respond appropriately to their infant’s specific sleep-related and social cues. This approach could help address broader parenting difficulties that may underlie infant sleep disturbances. An explanatory sequential mixed methods design combining a randomized controlled trial with thematic analysis of semi-structured family interviews was used to answer the following research questions: Quantitative - Does one dose of Play2Sleep delivered during home visits with mothers and fathers of 5-month-old infants with infant sleep disturbances reduce the number of night wakings at age 7 months? Qualitative - What are parental perceptions of family experiences, processes, and contexts related to Play2Sleep and infant sleep disturbances? Mixed Methods - How do parental perceptions of family experiences, processes, and contexts related to infant sleep explain the effectiveness of Play2Sleep? Play2Sleep was not effective in reducing parent-reported night wakings; however, it was effective in reducing maternal-reported infant nocturnal wakefulness and the number of paternal-reported naps. With Play2Sleep, there were significant subjective improvements in problematic infant sleep that were not observed in the comparison group. Three themes (information overwhelm, learning infant cues, and working together with a sub-theme of father involvement) were developed to propose a potential mechanism for Play2Sleep. Six themes describe broader parental experiences of infant sleep disturbances: developing routines; changed attitudes and beliefs; fears, concerns, and anxieties; support; sleep associations; and context of infant sleep disturbance. Play2Sleep shows promise to reduce infant sleep disturbances. Including fathers was novel and the qualitative analysis contributed to understanding the how and why of intervention effects. Areas for future research are prevention, precision-care models, workforce development, and parent engagement.
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    Sleeping for two: study protocol for a randomized controlled trial of cognitive behavioral therapy for insomnia in pregnant women
    (2021-08-12) MacKinnon, Anna L.; Madsen, Joshua W.; Dhillon, Ashley; Keys, Elizabeth; Giesbrecht, Gerald F.; Williamson, Tyler; Metcalfe, Amy; Campbell, Tavis; Mrklas, Kelly J.; Tomfohr-Madsen, Lianne
    Abstract Background Insomnia and sleep disturbances are common in pregnancy and have potentially significant consequences for both maternal and infant health. There is limited research examining the effectiveness of cognitive behavioral therapy for insomnia (CBT-I) during pregnancy. With increased distress and limited access to services during the COVID-19 pandemic, there is also an unprecedented need for telehealth delivery of treatment programs for pregnant women. The aims of this trial are to evaluate the impact of the Sleeping for Two adaptation of CBT-I in pregnancy (in-person or telehealth) versus treatment as usual (TAU) in reducing symptoms of insomnia (primary outcome), as well as increasing gestational length and reducing symptoms of depression (secondary outcomes). Methods A two-arm, single-blinded, parallel group randomized controlled trial (RCT) design with repeated measures will be used to evaluate the impact of CBT-I compared to TAU among a sample of 62 pregnant women, enrolled between 12 and 28 weeks of gestation, who self-identify as experiencing insomnia. Five weekly individual sessions of CBT-I will be delivered in person or via telehealth depending on physical distancing guidelines. Assessment of insomnia diagnosis by structured interview, self-reported insomnia symptom severity and sleep problems, and sleep quantity and quality as measured by a daily diary and actigraphy will occur at 12–28 weeks of pregnancy (T1), 1 week post-treatment (T2), and 6 months postpartum (T3). Discussion CBT-I delivered in pregnancy has the potential to reduce symptoms of insomnia and depression and could lead to reduced risk of preterm birth, all of which can minimize risk of negative maternal and child health and developmental consequences in the short (e.g., infant death) and long terms (e.g., developmental delays). This RCT builds on a successful open pilot trial conducted by our team and will provide further evaluation of a novel evidence-based treatment for pregnancy-related insomnia, which can be widely disseminated and used to treat individuals that are most in need of intervention. Findings will enhance understanding of pregnancy-related sleep problems, as well as means by which to improve the health and sleep of mothers and their children. Trial registration ClinicalTrials.gov NCT03918057. Registered on 17 April 2019.