This study investigated the relationship between sleep arrange-
ments and claims regarding possible problems and benefits
related to co-sleeping. Participants were 83 mothers of preschool-
aged children. Data were collected through parent question-
naires. Early co-sleepers (who began co-sleeping in infancy),
reactive co-sleepers (children who began co-sleeping at or after
age one), and solitary sleepers were compared on the dimensions
of maternal attitudes toward sleep arrangements; night wakings
and bedtime struggles; childrens self-reliance and independence
in social and sleep-related behaviours; and maternal autonomy
support. The hypothesis that co-sleeping would interfere with
childrens independence was partially supported: solitary slee-
pers fell asleep alone, slept through the night, and weaned earlier
than the co-sleepers. However, early co-sleeping children were
more self-reliant (e.g. ability to dress oneself) and exhibited more
social independence (e.g. make friends by oneself). Mothers of
early co-sleeping children were least favourable toward solitary
sleep arrangements and most supportive of their childs auton-
omy, as compared to mothers in other sleep groups. Reactive co-
sleepers emerged as a distinct co-sleeping sub-type, with parents
reporting frequent night wakings and, contrary to early co-
sleepers, experiencing these night wakings as highly disruptive.
Implications for parents and pediatricians are discussed.
Copyright # 2004 John Wiley & Sons, Ltd.
Key words: co-sleeping; parenting; independence; autonomy; sleep
problems
Sleep problems in infants and young children represent one of the most common
and pressing problems encountered in pediatric practice (Anders et al., 1992;
Benoit et al., 1992; Ferber, 1986). A vast pediatric and psychological literature
documents these sleep problems (e.g. Ferber, 1985a; Johnson, 1991; Weissbluth
et al., 1984; Zuckerman et al., 1987).
Copyright # 2004 John Wiley & Sons, Ltd. Received 18 October 2002
Received 27 July 2003
Accepted 27 July 2003
370 M.A. Keller and W.A. Goldberg
Difficulties in going to sleep and staying asleep are generally discussed within
the framework of normative behaviour in the U.S. and many other Western
countries in which infants and young children sleep in their own room, away
from their parents. In sharp contrast, in parts of the world in which infants and
young children co-sleep (that is, sleep in the same bed as their parents), reports of
sleep problems are virtually non-existent (Lee, 1992; Morelli et al., 1992). Notably,
parent-infant co-sleeping is an often misrepresented and oversimplified issue; it
is a controversial topic for which cultural ideologies and concerns for morality
are often mistaken for science (McKenna, 2000).
The current study of co-sleeping in a U.S. sample is conducted within the
framework of the developmental niche (Harkness, 1992; Super and Harkness,
1986), which has three interfacing elements: (1) the physical and social daily
environment in which children live; (2) the cultural customs of child rearing and
care practices; and (3) the psychology of the caretakers. This latter component
consists of parental beliefs and values (often influenced by the culture) regarding
effective child-rearing techniques, the competence of children at different ages,
and developmental goals for children.
When viewed through the lens of the developmental niche, co-sleeping and
solitary sleeping are child-rearing customs in which specific settings and
routines for sleep (e.g. sleep location) represent customary cultural practices
that reflect more general parental belief systems. Whether parents perceive sleep
behaviours such as night wakings and bedtime struggles to be irritating and
disruptive varies by culture, race, region, and socioeconomic background. For
example, in a U.S. sample, Lozoff and colleagues (1984,1996) reported a rather
high co-sleeping prevalence rate of 70% in a sample of AfricanAmerican
families and these families did not perceive night wakings to be problematic.
However, Caucasian parents who began co-sleeping after their child was one
year of age did find night wakings and bedtime protests to be problematic.
In a sample of Appalachian families, Abbott (1992) noted high rates of co-
sleeping, particularly in the childs first 2 years. These co-sleeping parents
did not report sleep problems and felt positively about their bedsharing
arrangements.
Cross-cultural studies point to similar conclusions. Morelli et al. (1992)
found that night wakings by children of Mayan Guatemalan mothers
were not reported to be a concern since the wakings were handled by
breastfeeding and followed by a quick return to sleep for both mother and
child. In Japan, co-sleeping was not found to be associated with sleep
problems such as bedtime protests or night time wakings (Latz et al., 1999;
Kawasaki et al., 1994); similarly, most Korean co-sleeping mothers reported that
even if their children did awaken during the night, crying did not constitute a
problem (Lee, 1992). In a study of new and experienced mothers in a
British community, a number of parents who had previously expressed no
intention to co-sleep ended up bringing their infants to bed and considered it to
be an effective and easy means of obtaining a good nights sleep (Ball et al., 1999,
p. 148).
More recent work by this research team indicated that not only mothers, but
also fathers, adjusted to the presence of the infant in their bed and found it a
satisfying and bonding experience that was more rewarding than disruptive (Ball
et al., 2000). Parental views about co-sleeping may change over time. Another
study conducted in Great Britain found that parental expectations and strategies
around sleep routines often changed as children moved from infancy to
toddlerhood (Morrell and Cortina-Borja, 2002).
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Co-Sleeping and Independence 371
Co-sleeping Sub-types
The above empirical work suggests that for U.S. families in which co-sleeping
typically began after the infant was 1 year of age in response to their childs
bedtime struggles, night wakings, and nighttime crying, parents found co-
sleeping to be stressful (Lozoff et al., 1984). Such reactive (Lozoff et al., 1996;
Madansky and Edelbrock, 1990) co-sleeping in toddlerhood may indicate that
parents bring their child into their bed in desperation, or as a matter of
convenience and expediency, but against their better judgment in response to
existing sleep problems. In contrast, co-sleeping was not associated with sleep
problems in U.S. families that began co-sleeping when the child was a young
infant, and in collectivist societies where parents chose to share the parental bed
with their young infant based on their values and beliefs in co-sleeping as a
desired and preferential child-rearing practice (Lee, 1992; Morelli et al., 1992;
Lozoff et al., 1996; Kawasaki et al., 1994). As a result, early co-sleeping families
may not experience brief night wakings as disruptive and may perceive them to
be natural in the course of their childs growth and development.
Researchers who have discussed possible explanations for the differential
reactions to co-sleeping have commented on the need to delineate sub-types of
co-sleeping families (Lozoff et al., 1996; Madansky and Edelbrock, 1990). They
note that future research should distinguish between children who sleep in their
parents bed beginning during the second year as a response to sleep problems
(i.e. reactive co-sleepers) and children whose families choose for their infants to
sleep in the parental bed beginning in infancy as a valued and preferred practice
(what we have termed early co-sleepers). The current study differentiates early
co-sleeping families and reactive co-sleeping families using chronological age
and sleep location so as not to confound sleep problems (such as night wakings)
with co-sleeping sub-types.
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372 M.A. Keller and W.A. Goldberg
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Co-Sleeping and Independence 373
parents get more rest (Medoff and Schaefer, 1993; Sears and Sears, 1993),
increases breastfeeding frequency and duration (Stein et al., 1997), positively
affects the childs self-esteem and discipline (Sears, 1987), increases feelings of
closeness between the parents and the child (Jackson, 1999; Thevenin, 1987),
reduces nighttime fears for toddlers and preschoolers (Jackson, 1999; Thevenin,
1987), and promotes security and sense of independence (Jackson, 1999;
Sears, 1987; Sears and Sears, 1993; Stein et al., 1997; Thevenin, 1987). From an
ethological perspective, closeness and proximity to the mother, especially
when the fear/wariness system is activated, promote the development of secure
infantparent attachment, which in turn fosters competence and relaxed
autonomous functioning as children grow older (Ainsworth et al., 1978; Bowlby,
1969).
Some empirical evidence supports the views that: co-sleeping is convenient for
parents [e.g. getting more rest (Ball et al., 1999), eases breastfeeding (Ball et al.,
1999; Hanks and Rebelsky, 1977; Morelli et al., 1992)] and promotes closeness (Ball
et al., 1999; Caudill and Plath, 1966; Hanks and Rebelsky, 1977). Extended
breastfeeding and physiological benefits also may accrue (McKenna and Mosko,
1990; Trevathan and McKenna, 1994). Emotional benefits for the child may
include decreased night-time fears and nightmares for young children (Forbes
et al., 1992; Sperling, 1971) and alleviation of loneliness due to the extended
absence of one parent (Forbes et al., 1992).
On the other hand, criticisms of co-sleeping include claims that co-sleeping
may lead to more sleep problems, especially bedtime struggles and increased
night wakings (Lozoff et al., 1984; Madansky and Edelbrock, 1990). Parents
interviewed in scientific studies echo pediatric concerns regarding encouraging a
habit that is hard to break, safety issues, and encouraging dependency in co-
sleeping children (Morelli et al., 1992). However, research has not yet empirically
evaluated these concerns.
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374 M.A. Keller and W.A. Goldberg
METHODS
Participants
Data are reported on 83 preschool-aged children and their mothers recruited
from Southern California preschools. Childrens ages ranged from 36 to 68
months (M 50.3, S:D: 8:6); 37.8% were 3-year-olds, 45.1% were 4-year-olds,
and 17.1% were 5-year-olds. Fifty-four percent of the children were female
(n 45) and 46% were male (n 38). The majority of children (72.3%) were first-
born children. The ages of the mothers ranged from 20 to 49 years (M 37:3,
S:D: 5:7), and fathers ages ranged from 21 to 60 years (M 40:3, S:D: 7:2).
Mothers were well-educated (80.4% had at least a 4-year college degree), middle-
to upper-middle-class (the median income was $80 000 to under $100 000), and
married (91.5%). The majority of the sample was Caucasian (70.7%); there also
were 15 Asian Americans (18.3%), 4 Latinas/Chicanas (4.9%), 2 Middle
Easterners (2.4%), 1 African American (1.2%), and 1 mother of mixed ethnicity
(1.2%). Room-sharers who were not bedsharers (n 4) were not included in the
current sample.
Procedure
Most participants were recruited through a convenience sample of preschools in
two Southern California counties. Of the nine preschool directors who were
contacted, 78% (n 7) consented to participate in the study. A recruitment letter
describing the study was distributed to mothers of preschoolers via each
preschool director. Survey packets were distributed to parents by the preschool
director or by a researcher; survey responses did not differ by mode of
distribution. Participants were instructed to return the survey packet to the
preschool within one week. Consent to participate was obtained through parental
review and signing of a consent form approved by the university Human
Subjects Review Board. Consent forms were immediately separated from the
questionnaires upon survey return so as to maintain participant confidentiality
and anonymity. The return rate for survey packets distributed at preschools was
41%, which is an acceptable response rate for this mode of data collection
(Tabachnick and Fidell, 1996). To ensure adequate representation in each of the
sleep groups, eight of the participating mothers of preschoolers in the sample
were recruited using a snowball sampling method (a field method in social
science research). In this method of recruitment, which is also known as chain
referral, target participants identified others who might be willing to be in the
study (Babbie, 1995; Sudman and Kalton, 1986). All of the participants contacted
through snowball sampling consented to participate. These surveys were
distributed and returned by mail.
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Co-Sleeping and Independence 375
Measures
Sleep Arrangements and Behaviours
The primary measure of sleep arrangements was the sleep practices
questionnaire (SPQ). A major section of the survey packet covered specific
topics such as childs sleep location, sleep-related behaviours, and maternal
attitudes and opinions toward childrens sleep behaviours and sleep arrange-
ments. Many items were adapted from Stillman (1999) on sleep arrangements,
Lozoff et al. (1984) on frequency and intensity of night wakings and bedtime
struggles, Lee (1992) on duration of night wakings and mothers perceptions as to
whether night wakings constituted a problem, and Crowell et al. (1987) on
parental opinion of sleep habits and problems; remaining items were developed
specifically for this study.
Sleep location was determined by asking participants about where their child
usually slept at birth, 6, 12, 24, and 36 months of age. Possible responses
included: own room, crib in parents bedroom, parents bed/own bed next to
parents bed, or sometimes crib/own bed and sometimes parents bed.
Responses to the sleep location by age items formed the basis for classification
into one of the three sleep groups. Following Lozoff et al. (1996), the age of 12
months was used as a point of demarcation for early versus reactive co-sleepers.
Solitary sleeping families were families whose child began sleeping in a separate
room around 6 months and continued sleeping separately through early
childhood. Early co-sleeping families were families whose child began sleeping
in the parental bed in early infancy for part if not all of the night as a regular sleep
arrangement, and continued co-sleeping past the age of 12 months and into the
second year. (Note that part-night co-sleeping does not include children who
simply fall asleep in the parental bed and are later moved to their own bed when
the parent is ready for bed.) In reactive co-sleeping families, infants slept in their
own room around 6 months and did not sleep in the parents bed prior to 12
months of age. These reactive co-sleepers first began co-sleeping for part or all of
the night at or after 12 months and the co-sleeping arrangement then persisted
for at least 6 months. In other words, reactive co-sleeping begins in the second or
third year, whereas early co-sleeping begins in early infancy. Notably, the criteria
for classification into sleep groups are based solely on sleep location and age
markers, and are not confounded with later sleep problems.
The SPQ included several items that concerned potentially problematic sleep
behaviours such as the frequency of night wakings and bedtime struggles, and
the extent to which the mother perceived each of these behaviours as
problematic. The frequency of night wakings was scored from 1 (never) to 5
(always), and the extent to which mothers perceived night wakings as
problematic was scored from 1 (not at all a problem) to 7 (definitely a
problem). Following Lee (1992), mothers also indicated how long their 12-month-
old child was awake during night wakings by checking the relevant category:
5 min or less, 615 min, 1630 min, or more than 30 min. For frequency of bedtime
struggles, possible responses were 1 (0 times per week or rarely), 2 (12 times
per week), and 3 (3 or more times per week). The extent to which mothers
perceived bedtime struggles as problematic was rated from 1 (not at all a
problem) to 5 (definitely a problem).
Maternal Attitudes
The SPQ also contained questions assessing maternal attitudes regarding sleep
arrangements. Participants were asked to rate on a Likert-type scale
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376 M.A. Keller and W.A. Goldberg
(1 strongly disagree and 6 strongly agree) how much they agreed with
statements concerning solitary sleeping and bedsharing (e.g. security, closeness,
neglect, convenience, trust, childs crying, developmental readiness, difficult-to-
break habits, independence, ease in childs transitioning to own room). A 12-item
scale of maternal attitudes toward sleep arrangements was created to tap the
extent of mothers endorsement of solitary sleeping and co-sleeping. After
reverse-coding selected items, the item scores were summed to yield a single
score with high scorers expressing more positive views towards solitary sleeping
and low scorers feeling more positively toward co-sleeping. Cronbachs alpha for
the scale was 0.92. Although construct validity information is not available for
this scale, its face validity appears to be strong. The SPQ also provided maternal
reports of demographic information about the family (e.g. parental age,
education level, income, ethnicity).
Childrens Independence
The final section of the SPQ tapped childrens attainment of sleep and adaptive
independence in specific areas. Independence was operationalized as the child not
relying on parents for help around sleep and other areas of daily living skills
(Goldstein et al., 1987; Raggio and Massingale, 1990; Ryan et al., 1995). Regarding
independence in sleep and daily adaptive living behaviours, mothers were
asked the age (in months) at which their child was able to fall asleep alone, sleep
through the night alone, wean from the breast, and toilet train.
A subscale of The Maturity Demands Scale (Greenberger and Goldberg, 1989)
was used to assess the attainment of mature behaviour in preschool-aged
children in the domains of self-reliance and social independence. The Maturity
Demands Scale targeted behaviours that indicate independence and autonomy
during the preschool years. Six items from the independence subscale were
included in the current study; these items reflect the extent to which the child
relies on himself/herself and exhibits social independence with peers (e.g. ability
to dress himself/herself, entertain himself/herself with a book or toy, work out
problems with playmates). A Likert-type response format was used, with the
scale ranging from 1 (never) to 7 (always). Cronbachs alpha for this scale was
0.68. In terms of discriminant validity, responses to this scale are generally
independent of social class as measured by level of education and occupational
prestige (Greenberger and Goldberg, 1989).
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Co-Sleeping and Independence 377
think, or feel in a certain way or towards particular outcomes). Eleven items from
the Harsh Control subscale of the Parental Control Scale (Greenberger and
Goldberg, 1989; Greenberger et al., 1994) (e.g. I have to keep my childs natural
curiosity firmly in check) were used in a Likert-type response format ranging
from 1 (strongly disagree) to 7 (strongly agree). Cronbachs alpha was 0.68 for
the maternal harsh control scale. The maternal autonomy support and maternal
control scales were correlated significantly and the combined alpha was 0.67.
Items from the two scales were summed to obtain a total score such that higher
scores reflected greater maternal autonomy support and lower scores reflected
greater maternal harsh control. Construct validity is supported by the finding
that mothers who describe themselves as harsher in disciplinary style were
observed to be less autonomy-fostering when helping their young child in a
challenging task situation (Greenberger et al., 1994).
Statistical Analysis
To test the hypotheses, group differences were evaluated using one-way ANOVA
for continuous variables. Preliminary analyses did not indicate significant
associations between demographic variables and sleep groups, but did reveal
significant associations with some study variables.1 In these instances, ANCOVA
analyses were conducted [e.g. night wakings (controlled for number of hours
mother works), childrens self-reliance and social independence (controlled for
sex of child and childs age), sleep and adaptive independence (controlled for
maternal age), and maternal autonomy support (controlled for childs age)].
Finally, a single discriminant function analysis was conducted to investigate, on a
multivariate level, relations between sleep arrangements and key discriminating
variables such as maternal autonomy support, childs independence, bedtime
struggles, night wakings, and attitude toward sleep arrangements. That is, this
analysis was performed to determine which attitudinal and behavioural
variables, overall, best characterized and differentiated each of the three sleep
groups.
RESULTS
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378 M.A. Keller and W.A. Goldberg
felt more positively about childrens sleeping alone, with reactive co-sleepers
falling distinctly in between the other two groups.
Bedtime Struggles
There was a trend noted between sleep arrangements and frequency of
bedtime struggles: mothers of reactive co-sleeping toddlers tended to report
more bedtime struggles than early co-sleepers (see Table 1). No significant
association was found between sleep arrangements and extent to which mothers
felt irritated by their childrens bedtime struggles at 2436 months.
Childrens Independence
Childrens Self-reliance and Social Independence
Controlling for child gender and age, a significant association was found
between sleep arrangements and childrens self-reliance and social independent
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Co-Sleeping and Independence 379
behaviours (see Table 1). However, the direction of the association was not as
expected. Ryan post hoc analyses revealed that early co-sleeping children, as
preschoolers, exhibited significantly more independent behaviours compared to
either solitary sleepers or reactive co-sleepers.
To examine the possibility that early co-sleeping children appear more
independent than reactive and solitary sleeping children due to maternal
behaviour, a follow-up analysis was run to test a mediating effect of maternal
autonomy support. The main effect of sleep groups remained significant,
F2; 81 5:25, p50.01, but the mediating variable of maternal autonomy support
was not significant, F31; 81 0:81 (n.s.).
Adaptive Independence
As expected, early co-sleepers weaned at a significantly later age
(M 16:6 months) compared to solitary sleepers (M 6:4 months) and reactive
co-sleepers (M 9:3 months), F2; 62 9:9, p50.001, controlling for maternal
age. In the area of toilet training, no significant relationship was found between
the age at the attainment of toilet training and sleep arrangements. (The mean age
for the sample was 30 to 32 months.)
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380 M.A. Keller and W.A. Goldberg
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Co-Sleeping and Independence 381
DISCUSSION
This study examined possible problems and benefits of co-sleeping, particularly
in relation to sleep problems, independence and autonomy. In addition, this
study differentiated sub-types of co-sleepers, offering distinctive correlates of
early co-sleeping and reactive co-sleeping.
With respect to attitude toward sleep arrangements, early co-sleeping mothers
felt less favourable toward solitary sleeping, whereas solitary sleeping mothers
strongly encouraged their children to sleep in their own room at an early age: in
these instances, maternal attitudes and sleep arrangements were congruent.
Interestingly, mothers of reactive co-sleepers held attitudes that were clearly in
the middle relative to the other two groups, reflecting the uncertainty of this
group about which arrangement to pursue and perhaps contributing to their
reports of more sleep problems.
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382 M.A. Keller and W.A. Goldberg
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Co-Sleeping and Independence 383
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384 M.A. Keller and W.A. Goldberg
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Co-Sleeping and Independence 385
ACKNOWLEDGEMENTS
The authors would like to thank Clarissa Castillo, Erin Eslick, An Pham, Esther
Chang, Shelly Brown, and Gary Germo for their help with the project. The
comments and suggestions offered during the peer review process also are
appreciated.
Notes
1. Although ethnicity did not relate significantly to any major study variable,
because of the non-trivial number of Asian Americans in our sample and
previous research on cultural differences in sleep arrangements, we ran a
series of descriptive analyses to contrast Asian Americans with other
ethnicities. Results pointed to striking similarities. For example, 44% of
AsianAmerican families were solitary sleepers, which was similar to the
proportion (40%) of solitary sleepers among European Americans. Asian
American mothers and mothers of non-Asian backgrounds were similar in
their attitudes toward solitary sleeping (means=3.32 and 3.55, respectively,
p > 0.10) and maternal autonomy support (means=71.19 and 73.86, respec-
tively, p > 0.10).
2. It is of interest to note that 4% of solitary sleepers (n=1), 24% of reactive co-
sleepers (n=6), and 62% of early co-sleepers (n=17) were not able to fall asleep
alone at the time the questionnaire was administered. No solitary sleepers
required the help of their parents in order to sleep through the night, whereas
26% of reactive co-sleepers (n=6) and 48% of early co-sleepers (n=13) were
unable to sleep through the night alone.
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386 M.A. Keller and W.A. Goldberg
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