Racial/ethnic disparities in infant sleep in the COVID-19 Mother Baby Outcomes (COMBO) study

• Published in: Sleep health 2022-10, Vol.8 (5), p.429-439
• Main Authors: Lucchini, Maristella, Ordway, Monica R., Kyle, Margaret H., Pini, Nicolò, Barbosa, Jennifer R., Sania, Ayesha, Shuffrey, Lauren C., Firestein, Morgan R., Fernández, Cristina R., Fifer, William P., Alcántara, Carmela, Monk, Catherine, Dumitriu, Dani
• Format: Article
• Language: English
• Subjects: Bedtime behavioral factors; COVID-19; Disparities; Ethnicity; Female; Hispanic or Latino; Humans; Infancy; Infant; Mothers; Race; Sleep; United States - epidemiology
• ISSN: 2352-7218; 2352-7226
• DOI: 10.1016/j.sleh.2022.06.010

Investigate racial and ethnic differences in infant sleep and examine associations with insurance status and parent-infant bedtime behavioral factors (PIBBF). Participants are part of the COVID-19 Mother Baby Outcomes (COMBO) Initiative, Columbia University. Data on infant sleep (night, day and overall sleep duration, night awakenings, latency, infant's sleep as a problem) were collected at 4 months postpartum. Regressions estimated associations between race/ethnicity, insurance status, PIBBF and infants’ sleep. A total of 296 infants were eligible (34.4% non-Hispanic White [NHW], 10.1% Black/African American [B/AA], 55.4% Hispanic). B/AA and Hispanic mothers were more likely to have Medicaid, bed/room-share, and report later infant bedtime compared to NHW mothers. Infants of B/AA mothers had longer sleep latency compared to NHW. Infants of Hispanic mothers slept less at night (∼70 ± 12 minutes) and more during the day (∼41 ± 12 minutes) and Hispanic mothers were less likely to consider infants’ sleep as a problem compared to NHW (odds ratio 0.4; 95% confidence interval: 0.2-0.7). After adjustment for insurance status and PIBBF, differences by race/ethnicity for night and day sleep duration and perception of infant's sleep as a problem persisted (∼32 ± 14 minutes, 35 ± 15 minutes, and odds ratio 0.4; 95% confidence interval: 0.2-0.8 respectively). Later bedtime was associated with less sleep at night (∼21 ± 4 minutes) and overall (∼17 ± 5 minutes), and longer latency. Infants who did not fall asleep independently had longer sleep latency, and co-sleeping infants had more night awakenings. Results show racial/ethnic differences in sleep in 4-month-old infants across sleep domains. The findings of our study suggest that PIBBF have an essential role in healthy infant sleep, but they may not be equitably experienced across racial/ethnic groups.