On this Papers Podcast, Professor Sooyeon (Aly) Suh discusses her co-authored JCPP paper ‘Validation of the Parental Understanding and Misperceptions about BAby’s Sleep Questionnaire utilizing auto-videosomnography’ (https://doi.org/10.1111/jcpp.13797).
There may be an summary of the paper, methodology, key findings, and implications for observe.
Dialogue factors embody.
- How prevalent paediatric sleep problems are and the way these sleep issues affect kids.
- The affiliation between parental cognition and youngsters’s sleep.
- How the questionnaire was developed and the cultural variations in sleep patterns.
- The significance of re-examining parental beliefs and attitudes about their little one’s sleep.
- Implications of the findings for researchers & how the findings may be translated into observe to help CAMH professionals and clinicians.
On this sequence, we converse to authors of papers revealed in considered one of ACAMH’s three journals. These are The Journal of Youngster Psychology and Psychiatry (JCPP); The Youngster and Adolescent Psychological Well being (CAMH) journal; and JCPP Advances.
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Professor Sooyeon “Aly” Suh is a medical psychology professor at Sungshin Girls’s College in Seoul, Korea. Professor Suh’s analysis focuses on behavioral sleep medication, together with making use of non-pharmacological interventions of insomnia to particular populations, comparable to PTSD sufferers, shift staff, and sufferers in main care. Her secondary analysis curiosity contains incorporating digital expertise into sleep analysis, comparable to wearables, auto-videosomnography, and digital apps. She has authored or co-authored a number of papers and chapters on these subjects.
Transcript
[00:00:07.520] Jo Carlowe: Whats up, welcome to the Papers Podcast sequence for the Affiliation for Youngster and Adolescent Psychological Well being, or ACAMH for brief. I’m Jo Carlowe, a Freelance Journalist with a specialism in psychology. On this sequence, we converse to authors of papers revealed in considered one of ACAMH’s three journals. These are the Journal of Youngster Psychology and Psychiatry, generally referred to as JCPP, the Youngster and Adolescent Psychological Well being, referred to as CAMH, and JCPP Advances.
Right now, I’m interviewing Dr. Sooyeon Suh, Affiliate Professor on the Division of Psychology at Sungshin Girls’s College in Seoul, Korea. Sooyeon, who additionally goes by “Aly,” is a co-author of the paper, “Validation of the Parental Understanding and Misperceptions About BAby’s Sleep Questionnaire Utilizing Auto-videosomnography,” lately revealed within the JCPP. This paper would be the focus of at present’s podcast. In case you’re a fan of our Papers Podcast sequence, please subscribe in your most well-liked streaming platform, tell us how we did, with a score or assessment, and do share with pals and colleagues.
Aly, welcome, thanks for becoming a member of me. Are you able to begin with an introduction about who you’re and what you do?
[00:01:16.570] Professor Sooyeon “Aly” Suh: Thanks a lot for having me and giving me this chance to share my analysis. I’m a Scientific Well being Psychologist by coaching and I’m one thing of what you’d name a Sleep Psychologist or a behavioural sleep medication specialist. So, what I do is I do numerous remedy and analysis round, type of, the psychological elements of sleep.
[00:01:38.830] Jo Carlowe: Wonderful, thanks. So, at present, we’re going to have a look at your paper. That is, “Validation of the Parental Understanding and Misperceptions About BAby’s Sleep Questionnaire Utilizing Auto-videosomnography,” lately revealed within the JCPP. To assist set the scene for us, Aly, are you able to inform us how prevalent paediatric sleep problems are and the way these sleep issues affect kids?
[00:02:01.119] Professor Sooyeon “Aly” Suh: So, once we discuss paediatric sleep issues, there’s normally three that we primarily discuss. The primary one is taking a very long time to go to sleep, which we name sleep onset issues, or having the kid get up in the midst of the evening and never having the ability to fall again asleep with none sort of parental intervention. Or one thing known as restrict setting issues, which suggests the kid intentionally continues to make requests with the intention of suspending bedtime, like, you realize, they want one other glass of water, they should go to the lavatory, and so forth. And analysis reveals that in kids ages six to 36 months, about 25 to 40% of youngsters do report having sleep issues, or their dad and mom do, and so, that’s about one in three kids, so it’s rather a lot.
[00:02:45.980] Jo Carlowe: Hmmm, unusual.
[00:02:46.980] Professor Sooyeon “Aly” Suh: And yeah, while some kids’s sleep issues would possibly naturally remit, it’s been proven via analysis that almost all paediatric sleep issues are more likely to persist with out – in the event that they’re not handled. And these untreated sleep issues could subsequently have a damaging impact on the kid’s growth, comparable to leading to the next prevalence of kid psychiatric problems or having extra aggressive behaviour and interfering with well being and studying outcomes.
[00:03:12.930] Jo Carlowe: Thanks, yeah, so extraordinarily impactful. Earlier than we go into the main points of the paper itself, are you able to inform us what is thought concerning the affiliation between parental cognition and youngsters’s sleep?
[00:03:24.810] Professor Sooyeon “Aly” Suh: Parental cognition can appear slightly little bit of a giant phrase and I, type of, wished to make clear first what we meant by that. Parental cognition about little one’s sleep refers to, type of, the beliefs and attitudes {that a} guardian has about how their little one ought to sleep. So, it’s, type of, the expectations surrounding, after which, oftentimes, these beliefs can, type of, form and affect how the guardian behaves related to the kid’s sleep. So, they may regularly test in additional or sleep with the kid proper subsequent to them, issues like that. And these behaviours, comparable to regularly checking in to see that – if the kid is sleeping, or instantly working to are likely to the kid, even with the slightest little bit of noise, can finally, have an effect on the amount and high quality of each the kid’s and the guardian’s sleep. So, we actually wished to have a look at this, type of, unseen variable that actually has a huge effect on how the guardian behaves and finally, how the kid sleep.
[00:04:18.769] Jo Carlowe: So, type of, a bidirectional relationship. Let’s flip to the paper, then. Are you able to give us an summary, what did you take a look at and why?
[00:04:26.630] Professor Sooyeon “Aly” Suh: So, this paper is a validation paper and we actually wished to develop a questionnaire specializing in the function of parental cognitions concerning the little one’s sleep. And what we actually wished to, type of, get out of the paper was arising with and growing a paper that was culturally inclusive. So, we did this with a thought in thoughts that we wished to indicate the affect of how paediatric sleep difficulties prolonged to how the dad and mom truly slept, as properly. So, we checked out each on this research.
So, type of, telling you slightly bit about how we developed the questionnaire. One problem that we bumped into once we began the analysis was that many of the questionnaires which have already been used within the subject had been actually centred in the direction of Western tradition. And I don’t know if you realize something about Korea, however I’m from Korea, the place sleeping tradition drastically, actually differs from many Western cultures. So, for instance, there’s much more co-sleeping happening and oftentimes, entire households sleep collectively in the identical room till the kid is kind of grown-up. And that is typically, you realize, only a cultural factor. It’s not essentially a, type of, a sleep downside.
So, there are all these totally different cultures that revolve round sleep, and among the questionnaires that we reviewed, that we wished to make use of in future research to have a look at parental cognition, type of, appeared slightly bit extra unfit for paediatric sleep analysis in cultures like Korea. So, what we did was, we, type of, took slightly bit extra of a bottom-up strategy. We interviewed ten Korean girls who had been at the moment experiencing sleep difficulties with their little one, after which, type of, compiled an inventory of statements that mirrored the beliefs and attitudes that they’d in the direction of their little one’s sleep.
So, whereas we did that, we additionally requested a bunch of world-renowned sleep consultants to assessment the gadgets that we had provide you with and add their very own experience from it, and we got here up with this questionnaire, that’s known as a “Parental Understanding and Misperceptions About BAby’s Sleep Questionnaire,” which can be named PUMBA-Q. Our research was known as SIMBA, so we, type of, had slightly little bit of a Disney theme happening there. After which, after we, type of, had these questions, we wished to verify statistically, that it was, type of, sound to make use of, and we name this course of validation.
And so, what we did was we had absolutely the pleasure of partnering with a US-based firm known as Nanit, and this firm specialises in a tool known as auto-videosomnography. So, this gadget is particularly designed to watch infants’ sleep in their very own pure surroundings, and it additionally, objectively measures sleep. And one of many issues that was very distinctive about that is that numerous the research which have already been completed with paediatric sleep analysis is that they, type of, took extra parental experiences, so paper and pencil measures, to measure infants’ sleep. Whereas this was measuring, so, infants’ sleep in their very own pure surroundings for a number of nights. And so, I believe that was, type of, a novel goal piece of it. And so, we did all of the statistical analyses and we discovered that there have been 4 sub-scales that, type of, got here up within the questionnaire.
[00:07:26.490] Jo Carlowe: Simply to return to the – to creating it culturally inclusive, the bias in the direction of Western attitudes and cultures in the direction of sleep would promote way more impartial sleeping, so…
[00:07:38.150] Professor Sooyeon “Aly” Suh: Proper. So, numerous the Western cultures, if you happen to take a look at, type of, how they measure parental cognition, it, type of, assumes that solitary sleeping is, type of, the norm. Type of, sleeping separate from their dad and mom is the norm, and that’s actually not the case for lots of Asian nations.
[00:07:54.560] Jo Carlowe: And simply in phrases, once more, like, an summary, are you able to simply say why it was vital, so vital to have a look at this space?
[00:08:01.819] Professor Sooyeon “Aly” Suh: So, you realize, numerous the occasions, while you take a look at behavioural sleep interventions for infants, higher referred to as sleep coaching, while you take a look at that, numerous them have been actually centered on altering the behaviour across the toddler’s sleep or the dad and mom’ sleeps.
One of many extra well-known strategies is one thing known as Cry-It-Out methodology or Ferber methodology, the place, you realize, you simply, type of, like, let the kid cry for an extended time period and the kid, type of, will get skilled to sleep on their very own. Which is okay, however I believe what a few of these strategies actually, type of, overlook is that the dad and mom which are all – which are driving the intervention, and if they’ll’t tolerate the coaching, or if they’ve these, type of, fears of isolation or abandonment of their previous, numerous the time it’s going to be actually exhausting for them to observe via, you realize, days of crying. And numerous the occasions, they fail. And we actually want to determine – you realize, we’ve these nice strategies of behavioural sleep interventions which are scientifically sound.
They’ve numerous good proof round them, and so they’re very protected, however we’re additionally seeing a reasonably low implementation price. And, you realize, I believe one of many key items to recollect is that the way in which that the dad and mom take into consideration their little one crying, or the way in which that they anticipate a toddler to sleep at a sure age, actually does affect how they need to actually prepare their little one to sleep.
[00:09:21.310] Jo Carlowe: Thanks. Let’s flip to the findings. Aly, what had been the important thing – if you happen to may spotlight among the key findings from the paper for us.
[00:09:29.480] Professor Sooyeon “Aly” Suh: A number of the key findings of the research was that we got here up with an inventory of things and thru a statistical methodology, one thing known as issue evaluation, the questionnaire, type of, consisted of 4 classes of how the dad and mom considered their little one’s sleep. So, the primary one was the misperceptions {that a} guardian might need particularly concerning the little one’s sleep. So, an instance merchandise may be, “If I don’t at all times know what my little one wants when my little one cries at evening, it means I’m a nasty guardian.” So, actually attributing all of the fault to themselves.
A second class was how they need to intervene when their little one cries or wakes up at evening. So, a pattern merchandise may be one thing like, “If I don’t reply straight away when my little one cries, it’ll negatively have an effect on his or her emotional growth.” So, catastrophising among the outcomes of the kid crying. After which, the third class was misperceptions about feeding. So, “If my little one wakes up at evening, it’s as a result of she or he is hungry.” After which, the fourth class was, type of, common nervousness of being a guardian. One thing like, “I’m afraid my little one would possibly die unexpectedly if I sleep individually with her or him.”
So, these are the 4 classes that we discovered the questionnaire gadgets to be, and once we appeared on the merchandise totals, so greater scores meant that they’d extra perceptions or dysfunctional beliefs concerning the little one’s sleep. What we discovered was that it was additionally extremely related to insomnia signs for fogeys. So, dad and mom who truly had extra dysfunctional beliefs, truly had extra insomnia signs. Very curiously, it was additionally very strongly associated with how a lot the infant truly slept.
So, I advised you about this auto-videosomnography gadget known as Nanit, and on daily basis, it was recording how lengthy the kid was sleeping. And what we did was, we divided the youngsters into three tertiles. So, you realize, one third, one third, and one third, and if you happen to, type of, evaluate the highest tertile and the underside tertile, the highest tertile infants slept 623 minutes. These had been the dad and mom who had the least variety of dysfunctional cognitions, and so they had been sleeping 623 minutes. Whereas, the dad and mom who had numerous dysfunctional cognitions, their infants had been sleeping 590 minutes. So, there was a few 30-minute distinction between the highest tertile and the underside tertile.
And whereas this would possibly – half-hour may not appear quite a bit to some individuals, you realize, if you happen to’re a guardian, half-hour is a very long time. So, truly, your little one sleeping half-hour undoubtedly means quite a bit to numerous dad and mom. So, I believe this was a reasonably large distinction that we discovered and it actually highlights that the way in which that you concentrate on your little one’s sleep actually shapes your behaviour. And if it shapes your behaviour and the way it intervenes, it’s going to, type of, intervene with among the practices which are extra well-known, that could be extra conducive to sleep, and that, finally, does have an effect in your little one’s sleep, as properly.
And actually extra curiously, so, one of many different issues that we measured was that the Nanit gadget, or the auto-videosomnography gadget, truly was able to measuring what number of occasions the dad and mom got here in, in the midst of the evening and checked in on their infants. And what we discovered was that the dad and mom who had greater scores on our questionnaire, truly confirmed extra parental interventions throughout the evening and reported much less confidence by way of their parentings. Additionally, we discovered that it was, type of, shaping their behaviour, as properly.
[00:12:52.279] Jo Carlowe: Yeah, it’s fascinating. So, it’s nearly a bit, type of, self-perpetuating. So, the extra nervousness laden the guardian is about – round their beliefs round sleep, the higher the probabilities that their little one will sleep much less properly, or much less lengthy, or…?
[00:13:05.060] Professor Sooyeon “Aly” Suh: Sure, after which, that additionally has an affect on their very own sleep, as a result of, you realize, their little one’s not sleeping as a lot, they’re not sleeping as a lot. And, you realize, the chi – the guardian’s not sleeping as a lot, I imply, we didn’t actually measure this in our research, however analysis has proven that oldsters not getting enough sleep actually does have an effect on their parenting practices. They’re much less delicate to their little one’s feelings, you realize, they may be extra irritable. You recognize, sleep has been very strongly tied with emotion regulation, in order that they may be slightly bit extra quick with their partner or their little one. I imply, there’s numerous totally different penalties that you could possibly consider that may be impacted by their little one not sleeping very properly.
[00:13:42.380] Jo Carlowe: So, vastly impactful findings, truly. Aly, what are the implications of your findings for Researchers?
[00:13:49.180] Professor Sooyeon “Aly” Suh: Effectively, we actually wished to, type of, spotlight and give attention to the significance of re-examining the beliefs and attitudes that oldsters might need about their little one’s sleep. It’s actually been under-researched. A number of it’s simply specializing in among the behaviour, and a few of these beliefs and ideas, or attitudes, had been in all probability handed on to you by your dad and mom. So, there’s a little little bit of a historical past there, and a few had been in all probability acquired via your personal life. However with out shut examination, there could also be some beliefs which are actually interfering with little one’s sleep and counterintuitive to sleep science, that you could be not even find out about. So, actually specializing in this as a subject, I believe, will likely be very useful in boosting among the remedy results that we have already got and likewise, serving to dad and mom take into consideration their very own historical past and excited about why they’re doing a little issues round their little one’s sleep.
I imply, the larger message is that paediatric sleep issues not solely impacts the kid negatively, however extends to the dad and mom’ wellbeing, as properly, and you realize, we actually don’t have numerous dialogue about how annoying parenting may be. And, you realize, I discussed earlier that I was a Scientific Well being Psychologist. I began out my analysis profession in stress analysis, and there have been these two Stress Researchers known as Holmes and Rahe, and what they did was they, type of, compiled an inventory of all of the annoying issues that would occur to an individual and will rank them. And what they discovered was that getting pregnant and having a toddler was truly extra annoying than going bankrupt or dropping an in depth pal. And so…
[00:15:17.200] Jo Carlowe: Ah.
[00:15:18.200] Professor Sooyeon “Aly” Suh: …you could possibly suppose that, you realize, being a guardian is annoying and we’d actually discuss quite a bit about among the extra optimistic elements about it, however I believe sleep is one the, type of, areas that’s most annoying to some dad and mom. And, you realize, I don’t suppose we actually realise that sufficient and actually discuss it sufficient. So, hopefully, it will open slightly bit extra dialogue about how this can be a annoying space for lots of fogeys and likewise, how there are some issues that actually may be completed about it.
[00:15:43.899] Jo Carlowe: Effectively, turning to the issues that may be completed about it, you talked about remedy earlier. How would possibly your findings be translated into observe to help CAMH professionals and Clinicians who work with households experiencing paediatric sleep issues?
[00:15:57.930] Professor Sooyeon “Aly” Suh: Many of the sleep interventions within the subject for kids are primarily centered on behaviours and behavioural interventions. So, a few of these issues are sleep routines or, you realize, Crying-It-Out, the Ferber methodology, are fairly well-known, and there’s actually been little to no give attention to parental cognitions as a goal for remedy. We actually don’t look at that, and it’s actually a giant barrier by way of implementing among the extra well-known evidence-based interventions. And likewise, the actually excellent news is that parental cognitions are a modifiable issue that may function a extremely good goal for interventions in sleep problems in kids. And so, we’ve, you realize, we’ve cognitive behavioural remedy, which is a really highly effective and efficient sort of remedy, and, type of, including this cognitive side into among the behavioural interventions which have already been established, I believe will likely be very useful.
One of many different attention-grabbing issues concerning the paper was that oldsters who had misperceptions and dysfunctional beliefs about their little one’s sleep additionally had extra greater scores about – on dysfunctional beliefs about their very own sleep, as properly. So, it simply may be like a common sleep concern. They in all probability have had sleep points up to now and it, type of, will get handed down and perpetuates as a generational factor. I believed that was, type of, an attention-grabbing piece that possibly must be mentioned slightly bit additional.
[00:17:16.679] Jo Carlowe: Are you planning any follow-up analysis, or is there the rest within the pipeline that you just want to share with us?
[00:17:22.630] Professor Sooyeon “Aly” Suh: I’m so glad you requested that query, as a result of the explanation why we truly developed this questionnaire was we had been truly actually considering designing an intervention that was primarily cognitive. And so, we simply didn’t like every of the measures that we discovered, so, we developed this questionnaire first. It was one of many first steps, and now, we’re, type of, in the midst of our medical trial, the place we’re evaluating cognitive intervention to an lively management group.
And what we’re doing is we’re actually making an attempt to make it extra conducive to parenting. The place, you realize, we’re assembly with dad and mom who’ve some downtime throughout their naptime, after which, we’ll meet with them and we’ll, type of, discuss slightly bit concerning the misperceptions they’ve about their little one’s sleep. And likewise, making it, actually, a cognitive intervention, the place we do, type of, the extra conventional cognitive behavioural remedy the place we fill out thought logs, we actually intently look at among the cognitive assumptions that they may have about little one sleep and possibly a few of that’s defective. And so, we, type of, take a really a lot cognitive strategy to that intervention.
And every thing is on-line, so we meet with them via our telehealth means, versus conventional face-to-face interventions, which is much more doable for some dad and mom who’re at residence with their little one and may’t depart. And typically, you realize, we’ll have mothers who’ve their little one on their lap, and we’ll nonetheless do remedy. So, it’s making an attempt to be slightly bit extra deliverable to, and accessible to those dad and mom. So, that’s within the pipelines and we’re within the center. We’ve simply recruited about half of the pattern, so hopefully, we’ll be speaking to you once more about our thrilling outcomes concerning the intervention.
[00:18:58.440] Jo Carlowe: It sounds actually thrilling, thanks. Aly, lastly, what’s your take residence message for our listeners?
[00:19:04.190] Professor Sooyeon “Aly” Suh: Effectively, I believe, as I discussed earlier than, you realize, being a guardian is a really annoying occasion for many individuals. I imply, I’m certain there are additionally very joyful elements of it, but in addition, you realize, we actually ought to take into consideration how parental sleep is admittedly vital within the context of toddler sleep. They’re, type of, actually tied collectively, and in case your little one doesn’t sleep, the guardian doesn’t sleep, and if the guardian doesn’t sleep, there are numerous implications to the way you’re going to deal with your little one and the way you’re going to guardian your little one. And so, if you happen to’re not getting sufficient sleep, it’s best to actually, you realize, see a sleep skilled.
In case your little one’s not getting sufficient sleep, or if little one is having some sleep difficulties, there are some fantastic, fantastic evidence-based sleep interventions on the market that may assist you, which have been actually established as protected and long-term and have good upkeep and good impact sizes. So, undoubtedly don’t hesitate to, type of, search assist if you happen to really feel you want it.
[00:19:57.550] Jo Carlowe: Thanks ever a lot. Are there any specific interventions that you just wish to point out?
[00:20:02.429] Professor Sooyeon “Aly” Suh: So, the three interventions which have been advisable by the American Academy of Sleep Drugs are – one is known as ‘normal extinction’, which is, I believe, extra well-known as you simply depart your little one there and also you, type of, allow them to cry it out slightly bit. I believe it’s slightly bit unpopular with numerous dad and mom, as a result of they don’t – actually don’t like to listen to their little one cry. So, that’s the primary strategy.
The second is known as ‘graduated extinction’, the place it’s slightly bit extra of a modified strategy to the usual extinction, the place you, type of, you realize, area out the time that you just go in to test in along with your little one, and I believe that one is slightly bit extra common and likewise, efficient. After which, the third one is known as ‘tenting out’, the place you’re nonetheless within the room and there may be nonetheless a parental presence till your little one falls asleep, and that’s undoubtedly much more modified.
So, I believe, you realize, with all these interventions, I do know there’s numerous controversy round it, however it’s actually discovering the best steadiness between how a lot limit-setting you are able to do and what your nervousness degree is. There’s not a one dimension suits all for anybody. Everybody’s little one is totally different. Everybody’s little one goes to react in a different way to the totally different interventions, and likewise, the dad and mom are totally different. So, you simply have to search out the best intervention for you, that’s efficient, and my solely major message is that you just shouldn’t undergo.
[00:21:16.700] Jo Carlowe: Aly, thanks ever a lot. Thanks for sharing extra particulars about your analysis with us. For extra particulars on Dr. Sooyeon Suh, please go to the ACAMH web site, www.acamh.org, and Twitter @ACAMH. ACAMH is spelt A-C-A-M-H, and don’t neglect to observe us in your most well-liked streaming platform, tell us if you happen to benefit from the podcast, with a score or assessment, and do share with pals and colleagues.
