Older babies 'sleep better in their own room'

"Babies who sleep in separate rooms from their parents have earlier bedtimes, take less time to nod off and get more shut eye," the Mail Online reports on the results of an international survey looking at sleeping locations and outcomes in infants aged 6 to 12 months.

The parents of more than 10,000 infants aged 6 to 12 months completed an app-based questionnaire. As this was a US-based study, the results were split into two categories: the United States and international (Australia, Brazil, Canada, Great Britain and New Zealand).

The results showed babies who slept in separate rooms slept longer, got to sleep quicker, and were more likely to have a bedtime routine than those who slept in the same bed or room as their parents. Parents were also less likely to perceive bedtime as difficult.

The results seem to confirm the findings of a much smaller study we discussed back in June.

But a range of external factors, such as home environment, breastfeeding, and interaction with family and other caregivers, might also affect babies' sleep.

We can't say for certain that separate rooms are better for all infants. The study didn't look at the effect of babies sharing a room with a sibling, for example.

Current NHS guidance recommends keeping your baby in the same room as you in a separate cot for the first six months.

Placing your baby on their back to sleep from the very beginning, for both day and night sleeps, will reduce the risk of sudden infant death syndrome (SIDS).

Where did the story come from?

The study was carried out by researchers from Saint Joseph's University, Philadelphia, the Children's Hospital of Philadelphia, and Johnson and Johnson Consumer, all in the US.

It was funded by Johnson & Johnson, a multinational medical devices, pharmaceutical and consumer packaged goods manufacturing company, who also developed the mobile app used in this research.

There doesn't seem to be any conflict of interest on the part of the researchers, as the results of the study had no obvious commercial implication.

The study was published in the peer-reviewed journal Sleep Medicine.

The Mail Online generally reported accurately on the results of the study itself, but got muddled by claiming that the findings "contradict guidelines by the American Academy of Pediatrics (AAP), which recommends babies sleep in the same room as their parents for at least the first six months to reduce their risk of sudden infant death syndrome (SIDS)".

This is neither true nor relevant – the study didn't look at the first six months of life, it investigated infants aged 6 to 12 months.

What kind of research was this?

This cross-sectional study used a questionnaire on an app to examine babies' sleep patterns, behaviours and problems in both a US and international sample of infants.

The researchers aimed to see if sleeping arrangements (where the infant slept) affected these sleep-related outcomes.

This type of research can identify patterns and associations between sleep location and sleep outcomes at a specific snapshot in time, but can't show trends over time or look at longer term outcomes.

It also can't determine cause and effect – in other words, that where a baby sleeps directly causes certain sleep outcomes. A range of other factors could also influence this.

Also, it's possible that parents of babies with underlying sleep problems unrelated to where they sleep just prefer to put them in the same bedroom because it's easier for them if their child wakes in the night.

What did the research involve?

The research involved 6,236 infants and their parents from the US, and 3,798 participants from Australia, Brazil, Canada, Great Britain and New Zealand, who all had infants aged between 6 and 12 months. It looked at the association between sleep location and sleep outcomes.

Participants completed a smartphone app-based expanded version of the Brief Infant Sleep Questionnaire (BISQ). They also reported demographic information. The app, Johnson's Bedtime Baby Sleep, was free and publicly available.

The questionnaire recorded expected developmental changes in infants and the potential influence of environmental factors.

It asked questions on:

sleep location in relation to parents: room-share, bed-share or separate sleeping (sharing with siblings was excluded)
infant daytime and night-time sleep patterns
sleep-related behaviours, such as how long it takes to fall asleep or how many times an infant wakes during the night

The app also included:

an electronic sleep diary
information on bedtime routines
lullabies
an online intervention – the intervention uses sleep data gathered by the app and then provides customised advice based on the data provided

What were the basic results?

The researchers found 37.2% infants aged 6 to 12 months from the US, and 48.4% in the international sample, slept in a separate room from their parents.

US infants sleeping in a separate room:

had significantly earlier bedtimes (20:08pm) than those room-sharing or bed-sharing (20:43pm and 20:52pm, respectively) – they also took less time to get to sleep (32.04 minutes versus 45.67 and 42.31, respectively)
woke up less in the night (2.00) than room-sharers (2.35) or bed-sharers (2.61), had a greater longest stretch of sleep (6.75 hours versus 5.88 and 5.33), and had a longer night-time sleep (9.57 hours versus 8.81 and 8.89)
were more likely to be reported as having a consistent bedtime routine (72.8% versus 56.0% room-share versus 51.5% bed-share) and more likely to fall asleep independently (35.5% versus 30.3% versus 17.4%)
resulted in fewer parents perceiving bedtime to be difficult (27.1% versus 37.1% room-share versus 42.3% bed-share) or their child having problems falling asleep (33.1% versus 43.6 room-share versus 48.1% bed-share)

Similar results were found for the international sample.

How did the researchers interpret the results?

The researchers concluded: "These results indicate that infants aged 6 to 12 months who sleep in a separate room have better parent-reported sleep outcomes in terms of increased sleep duration and sleep consolidation, as well as better sleep health practices (i.e. conforming with commonly recommended sleep behaviours) and parent perception of infant sleep."

Conclusion

This study seems to show that parents of infants aged 6 to 12 months who sleep in a separate room report better infant sleep outcomes, such as sleep times and sleep duration, than parents who keep their infant in the same room or bed.

These findings are similar to a study covered in June 2017, which found "independent sleepers" slept for longer aged nine months than room-sharers.

But there are some considerations that need to be taken into account:

This questionnaire-based study didn't follow infants over a long period of time, so we only know about their sleep behaviours and patterns at one particular time, not over a long period.
Many external factors might also contribute to sleep patterns and behaviours, including breastfeeding, interaction with family members and caregivers, having siblings, the home environment, and possibly cultural differences.
Parent-reported answers may not be accurate. For example, not all parents are going to closely time how long it takes their child to fall asleep or what their longest stretch of sleep is. There could also be potential for some bias in reporting, such as under-reporting sleep disruption in case this is perceived as them not coping well.
The majority of caregivers who responded to the questionnaire were mothers. The results might have been different if other caregivers had responded.

If your baby is over the age of six months, there are no known health reasons why they can't sleep safely in their own room as long as they're always placed on their back to sleep.

Get advice about sleep problems in young children.