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Infant and Child Development

Inf. Child Dev. 13: 369388 (2004)


Published online in Wiley InterScience (www.interscience.wiley.com). DOI: 10.1002/icd.365

Co-Sleeping: Help or Hindrance for


Young Childrens Independence?
Meret A. Keller and Wendy A. Goldberg*
Department of Psychology and Social Behaviour, School of Social Ecology,
University of California, Irvine; Irvine, CA, USA


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).

*Correspondence to: Wendy A. Goldberg, Department of Psychology and Social


Behaviour, 3375 Social Ecology II, University of California, Irvine, CA 92697, USA.
E-mail: wagoldbe@uci.edu

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.

Childrens Independence, Autonomy and Sleep Practices


From the perspective of the developmental niche (Harkness, 1992; Super and
Harkness, 1986), parental belief systems and child-rearing customs reflect
parental goals for their childrens development. U.S. parents whose children
sleep separately often cite the development of their childrens independence as
the main reason for that specific sleep arrangement (Morelli et al., 1992; Richman
et al., 1988). Conversely, co-sleeping parents choose to keep their children nearby
during the night to nurture a sense of connectedness and security (Morelli et al.,
1992). A major criticism of co-sleeping posits that if children do not sleep by
themselves, the developmental goals of autonomy and independence will be
derailed (e.g. Brazelton, 1992; Ferber, 1985b). The argument that sleeping alone is
crucial to the development of independence rests on the assumptions that (1)
solitary sleeping from infancy forward is a necessary prerequisite to the
attainment of independence, and that (2) if independence in the realm of sleep
is achieved, then children will be independent in other developmental domains.
Although experts are quick to equate co-sleeping with excessive dependency and
parents often endorse solitary sleeping as a means to set the stage for
independent development, empirical data linking sleep arrangements and young
childrens independent behaviour, including a discussion of what is meant by
independence, has been lacking.
In settings ranging from anthropological to psychological to medical, the
increasing ability of children to rely on themselves instead of others in self-care,

Copyright # 2004 John Wiley & Sons, Ltd. Inf. Child Dev. 13: 369388 (2004)
372 M.A. Keller and W.A. Goldberg

social, and adaptive domains has been conceptualized and operationalized as an


important marker of independence in early childhood (Erikson, 1963; Whiting
et al., 1966; Olsen, 1973; Sroufe et al., 1983; Deci and Ryan, 1985; Raggio and
Massingale, 1990; Deci et al., 1993). Due to the unsubstantiated conventional
wisdom about sleep arrangements and independence, we felt it important to
examine independent sleep behaviours in infants and young children with
various types of family sleep situations. We also decided not to view
independence as a monolithic construct, which would presume that children
who are independent in one domain are also independent in other domains.
Rather, we included areas of independence in addition to sleep-related
behaviours, to study whether children who depend on adults for sleep (i.e. do
not fall asleep or sleep through the night without adult presence or assistance)
are independent in other areas of development. Operationally, then, independent
sleep behaviours entail falling to sleep alone and sleeping through the night (or
returning to sleep during the night) without adult assistance. Whereas it may
seem paradoxical to examine independent sleep behaviours in co-sleeping
children, some young children may go to sleep without adult assistance and
nearly all eventually transition to independent sleeping. In this study we
examine the extent of the disparity in the acquisition of independent sleep
behaviours between solitary sleepers and co-sleepers.
A related but conceptually distinct construct, autonomy, has been defined as a
high degree of experienced choice with respect to the initiation and regulation of
ones own behaviour (Deci and Ryan, 1985, p. 111). Self-determination theory
(Deci and Ryan, 1985) stresses the importance of childrens initiative in self-
regulatory activities. Parents who support their young childrens autonomy
value and use techniques which encourage independent problem solving,
choice, and participation in decisions versus externally dictating outcomes
(Grolnick and Ryan, 1989, p. 144). Autonomous children are encouraged to
regulate their own behaviour and act with a sense of choice, initiative, curiosity,
and an authentic sense of self within an environment that is regulated by clear
parental guidelines. Thus, on the one hand, one would expect parents who let the
child take the lead in making decisions around going to sleep and returning to
sleep would be supporting the childs autonomy, regardless of whether the
childs lead-taking involved co-sleeping or solitary sleeping. Paradoxically, co-
sleeping per se has been inevitably linked to dependency in the minds of many
pediatric expects as solitary sleeping has been seen as a guarantor of
independence.
Grounded in developmental theory and research on independence and
autonomy (Deci and Ryan, 1985; Erikson, 1963; Grolnick and Ryan, 1989; Ryan
and Deci, 2000; Ryan et al., 1995; Sroufe et al., 1983), this study examines the age at
which children attain independence in sleep and other social and adaptive
behavioural domains. Importantly, this study targets sleep, self-reliant and social
behaviours that signify independence and autonomy during the preschool years
(Greenberger and Goldberg, 1989; Sroufe et al., 1983) and examines whether these
preschool-aged behaviours are related to earlier sleep arrangements.

Claims about Problems and Benefits of Co-sleeping


Parents and pediatric experts who support co-sleeping believe that its benefits
extend to both children and parents. Specifically, some advocates suggest that co-
sleeping allows for a convenient way to manage night-time wakings so that

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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.

The Current Study


The primary objective of this study was to provide empirical data on purported
benefits and problems that have been linked to co-sleeping, particularly in
relation to sleep-related behaviours and childrens independence and autonomy.
A secondary aim of this study was to improve the understanding of the sub-types
of co-sleeping and to identify variables that best differentiate solitary and co-
sleeping groups.
The following four hypotheses were examined: (1) early co-sleeping mothers
view solitary sleeping more negatively and co-sleeping more positively than
either solitary sleeping or reactive co-sleeping mothers. No differences in
maternal attitudes are expected between solitary sleepers and reactive co-
sleepers; (2) reactive co-sleeping mothers experience more child-related sleep
problems such as night wakings and bedtime struggles when children are 23
years of age and perceive these problems as more intense than do solitary
sleeping and early co-sleeping mothers; (3) solitary sleeping children exhibit
greater self-reliance and more independence in social matters at preschool age
compared to early co-sleeping children and reactive co-sleeping children; and (4)
early co-sleeping mothers are more supportive of their childs autonomy and
exhibit less controlling behaviour than solitary sleeping or reactive co-sleeping
mothers. The direction of hypothesis 3 follows from extant expert opinion about
solitary sleep and later independence but this assumption has not heretofore

Copyright # 2004 John Wiley & Sons, Ltd. Inf. Child Dev. 13: 369388 (2004)
374 M.A. Keller and W.A. Goldberg

been tested empirically. Hypothesis 4 is grounded in self-determination theory


(Ryan and Deci, 2000), which would suggest that parents who are less controlling
of their childs behaviour in the sleep domain will be less controlling and more
autonomy supporting in other domains as well. Finally, we include multivariate
analyses to examine the attitudinal and behavioural characteristics that best
differentiate the three types of sleep arrangements (early co-sleepers, reactive co-
sleepers and solitary sleepers).

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.

Copyright # 2004 John Wiley & Sons, Ltd. Inf. Child Dev. 13: 369388 (2004)
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).

Maternal Autonomy Support and Control


Following Grolnick and Ryan (1989), maternal autonomy support was defined
as behaviour that provides choice and encourages a childs initiative, responsibility,
independent problem solving, exploration, and participation in decision-making.
Maternal autonomy support was assessed using the parental attitudes toward
childrearing (PACR) (Easterbrooks and Goldberg, 1984). The scale taps four
dimensions of parental attitudes toward childrearing: warmth, strictness,
aggravation, and encouragement of autonomy/independence. This 51-item scale
uses a Likert response format from 1 (strongly disagree) to 7 (strongly agree).
For the purposes of this study, an adaptation of the encouragement of autonomy
subscale was used (3 items, e.g. I let my child make many decisions for himself/
herself). Cronbachs alpha for the 3 items was 0.63.
To reflect conceptual issues raised by Deci and Ryan (1985) as to the possibility
that autonomy support and control may exist on a continuum, a measure of
maternal control was included (i.e. behaviour that pressures a child to behave,

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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

Before presenting the main analyses, we provide descriptive information about


the sleep arrangements in this sample. Thirty-nine percent of the mothers
(n 32) indicated that their children were solitary sleepers, 34% of the mothers
(n 28) had children who were early co-sleepers, and 28% of the mothers
(n 23) reported the reactive pattern of co-sleeping. Of the 23 reactive co-
sleepers, 26% (n 6) began co-sleeping around the age of 12 months, but most
mothers of reactive co-sleepers (74%, n 7) reported that co-sleeping did not
begin until around age two or later. Night wakings appeared to be of a routine
nature: of the children who had night wakings at 12 months, 60% were awake
5 min or less, and only 13% were awake for more than 15 min.

Maternal Attitude Toward Sleep Arrangements


Sleep arrangements and mothers attitudes toward these arrangements were
found to be significantly related (see Table 1). Ryan post hoc analyses revealed that
early co-sleepers felt more positively towards bedsharing and solitary sleepers

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378 M.A. Keller and W.A. Goldberg

Table 1. Comparison of Solitary Sleepers, Reactive Co-Sleepers, and Early Co-Sleepers on


Study Variables
Study variables Solitary Reactive Early F (df)
sleepers co-sleepers co-sleepers
Attitude toward sleep 4.26 3.65 2.48 F2; 80 54:4***
arrangementsa (M)
Potential sleep problems
Frequency of night wakingsb (M) 2.28 3.32 3.00 F3; 79 4:4**
Whether night wakings 1.88 3.77 2.22 F3; 79 7:3***
problematicb (M)
Frequency of bedtime strugglesb (M) 1.61 2.04 1.57 F2; 81 2:89+
Bedtime struggles problematicb (M) 2.08 2.37 1.98 F2; 81 0:75 (n.s.)
Independence
Childs self-reliance and 28.66 26.39 32.61 F3; 79 10:0***
social independenceb (M)
Maternal autonomy supportb (M) 69.43 70.13 80.70 F3; 77 8:5***
a
Higher scores indicate greater agreement with statements favouring solitary sleeping (1 strongly
disagree and 6=strongly agree).
b
Higher scores indicate greater frequency or endorsement of the construct.
+
p50.10; *p50.05; **p50.01; ***p50.001.

felt more positively about childrens sleeping alone, with reactive co-sleepers
falling distinctly in between the other two groups.

Reported Sleep Problems by Sleep Arrangements


Night Wakings
After controlling for number of hours mother worked, the results indicated a
significant relationship between sleep arrangements and frequency of night
wakings (see Table 1) at 2436 months. Ryan post hoc analyses revealed that early
co-sleeping children and reactive co-sleeping children awakened significantly
more frequently than solitary sleeping children. That is, both types of co-sleeping
children awakened sometimes whereas solitary sleeping children awakened
rarely. Mothers in reactive co-sleeping arrangements perceived their childrens
night wakings to be significantly more problematic compared to the other two
groups (see Table 1). Inspection of means indicated that mothers in reactive co-
sleeping arrangements found their childrens night wakings to be somewhat a
problem; mothers of early co-sleeping children and solitary sleeping children
indicated that their childrens night wakings were rarely a problem.

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.).

Independent Sleep Behaviours


When investigating two independent sleep behaviours (the ability to fall asleep
alone and the ability to sleep through the night alone), it was possible to run
analyses only for the sub-sample of 48 mothers who indicated an age when their
child was able to fall asleep alone and the 50 mothers who reported an age when
their child was able to sleep through the night alone. The mothers who did not
provide an age had children who had not yet attained independence on these
sleep-related behaviours; these mothers disproportionately fell into the early co-
sleeping arrangement.2 Thus, analyses among the respondents who provided
ages for independent sleep behaviours likely reflect conservative estimates of the
differences among the groups.
Analyses of covariance (ANCOVA) revealed a significant relationship between
sleep arrangements and the two independent sleep behaviours. Controlling for
maternal age, Ryan post hoc analyses indicated that early co-sleepers were able
both to fall asleep alone [F2; 48 22:8, p50.001] and sleep through the night
alone [F2; 50 16:5, p50.001] at a significantly older age than reactive co-
sleepers, who in turn were significantly older than solitary sleepers. Interestingly,
of the children whose mothers reported an age at which their child was able to
fall asleep alone (n 48), the mean age was 5.0 months for solitary sleepers, 11.0
months for reactive co-sleepers, and 26.9 months for early co-sleepers. Of the
children whose mothers indicated their child was able to sleep through the night
alone (n 50), the mean age for attainment of this behaviour was 6.2 months for
solitary sleepers, 13.6 months for reactive co-sleepers, and 25.5 months for early
co-sleepers.

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.)

Maternal Autonomy Support and Control


The results provided evidence to support the hypotheses regarding maternal
autonomy support. After controlling for childs age, a significant relationship
existed between sleep arrangements and maternal autonomy support and
control. Based on Ryan post hoc analyses, early co-sleeping mothers were

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380 M.A. Keller and W.A. Goldberg

significantly more supportive of their childs autonomy (e.g. allowed their


children to make many decisions for themselves, exhibited less harsh control)
compared to either reactive co-sleeping mothers or solitary sleeping mothers (see
Table 1).

Multivariate Consideration of Sleep Arrangements in Relation to Major Study


Variables
To examine which of the major study variables best distinguish membership into
the three sleep arrangement groups, a discriminant function analysis was
performed. Independent variables were attitude towards sleep arrangements,
frequency of night wakings, frequency of bedtime struggles, whether night
wakings problematic, childs independence, and maternal autonomy support
and control. Covariates of childs age, sex of child, and number of hours mother
worked were entered in the analysis.
Two discriminant functions were calculated, with a combined x2 18 91:5,
p50.001. After removal of the first function, there was still strong association
between groups and independent variables, x2 8 21:0, p50.01. The first
discriminant function accounted for 83% of the between-group variability and
the second function accounted for 17%. As shown in Figure 1, the first
discriminant function maximally separates early co-sleepers from the other two
sleep arrangement groups. The second discriminant function discriminates
reactive co-sleepers from solitary sleepers and early co-sleepers. The loading

Figure 1. Plots of centroids for sleep groups on two discriminant functions.

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Co-Sleeping and Independence 381

Table 2. Discriminants of sleep arrangements: results of discriminant analysis of six


study variables and three covariates
Independent variable Correlations of independent variables
with discriminant functions
1 2
*
Attitude toward sleep arrangements 0.87 0.21
Maternal autonomy support 0.42 0.13
Childrens self-reliance and social independence 0.31 0.38
Frequency of night wakings 0.17 0.63*
Whether night wakings problematic 0.01 0.89*
Frequency of bedtime struggles 0.06 0.43
Sex of child 0.10 0.09
Age of child 0.01 0.09
Number of hours mother works 0.11 0.16
*
Factor loadings greater than 0.5 are significant.

matrix of correlations between independent variables and discriminant func-


tions, as seen in Table 2, suggests that the best variable for distinguishing
between early co-sleepers and the other two sleep groups (first function) are
attitudes toward sleep arrangements. Early co-sleepers have a less favourable
attitude toward solitary sleep arrangements (M 2:49) compared to reactive co-
sleepers (M 3:66) or solitary sleepers (M 4:25). Loadings less than 0.50 are
not interpreted (Tabachnick and Fidell, 1996).
Two variables had a loading greater than 0.50 on the second discriminant
function, which separates reactive co-sleepers from the other two sleep groups.
The best discriminator of these three groups was whether night wakings were
problematic, followed by frequency of night wakings. The reactive co-sleeping
group reported the most problems with their childs night wakings
(M 3:78) compared to the solitary sleeping group (M 1:81) and the true co-
sleeping group (M=2.27). Similarly, reactive co-sleepers reported more night
wakings (M 3:32) compared to solitary sleepers (M 2:26) and early co-
sleepers (M 3:00). Overall, sleep problems in the form of night wakings
appeared to distinguish reactive co-sleeping from solitary sleepers and early
co-sleepers.

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

Compared to early co-sleeping and solitary sleeping mothers, reactive co-


sleeping mothers reported experiencing more sleep problems overall. Specifi-
cally, both early co-sleeping toddlers and reactive co-sleeping toddlers awakened
more frequently during the night compared to solitary sleepers. This finding is
consistent with most of the previous U.S. literature regarding co-sleeping in
general. However, a main finding of this study was that only mothers of reactive
co-sleepers experienced their childrens night wakings as disruptive. Early co-
sleepers in this sample may be similar to co-sleepers in other cultures (Lee, 1992;
Morelli et al., 1992) and specific groups in the U.S. (Abbott, 1992; Lozoff et al.,
1996; Morelli et al., 1992) in that night wakings are not perceived as problematic.
With respect to bedtime issues, reactive co-sleeping mothers appeared to endure
more frequent bedtime issues than either of the other two groups of mothers.
However, bedtime issues appeared to be less disruptive to the family routine
than night wakings. Perhaps this was because bedtime struggles were more
expected during the familys evening routine, or parents simply adapted to them,
whereas night wakings contributed to an unwelcome disruption of parents sleep
in the middle of the night.
The multivariate model indicated that the characteristics that best differen-
tiated the three sleep groups were attitudes toward sleep arrangements: early co-
sleepers had a less favourable attitude toward the practice of children sleeping
separately, an attitude that strongly differed from the other two groups.
Frequency of night wakings and whether night wakings were considered
problematic were the characteristics that next best distinguished the groups:
reactive co-sleepers were the sole group to experience frequent night wakings as
well as find them highly disruptive. The implication of these findings is that the
success or difficulty that different parents have with various sleep arrangements
depends not on the practice itself, but what parents bring to the practice in terms
of their beliefs, values, parenting styles and goals.
These findings challenge much of the sleep literature that claims co-sleeping
per se to be associated with sleep problems, and highlight the need for future
research to continue to study the two distinct types of co-sleeping. In this study,
reactive co-sleeping arrangements were defined by age and sleep location, not by
whether there were sleep problems involved. The literature is unclear as to which
definition should be used}chronological age (whether co-sleeping began in
infancy or after the child was 1 year of age) or whether co-sleeping was used as a
reactive attempt to address child sleep problems}or both. Based upon the
findings of this study, we recommend against confounding sleep arrangements
and sleep problems in future research on co-sleeping.
With respect to childrens independence, we found that children in solitary
sleep arrangements fell asleep alone, slept through the night alone, and weaned
from the breast at an earlier age compared to reactive co-sleepers and early co-
sleepers. The differences were non-trivial. For example, more than one and one-
half years separated the mean age at which solitary sleepers fell asleep alone as
compared to early co-sleepers. If early independence training in sleep and
weaning is a cultural or familial value, then solitary sleeping is the sleep
arrangement most consistent with this value. It may be that parents of solitary
sleepers do not rely on active physical comforting (e.g. cuddling, rocking,
carrying) to put their infants and toddlers to sleep (Morrell and Cortina-Borja,
2002). Perhaps parents of children who exhibit independent sleep behaviours at
an early age follow recommendations such as Ferbers (1985b), in which wrong
sleep associations such as rocking, nursing, and holding are replaced with
correct sleep associations (i.e. creating a sleep environment that does not require

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Co-Sleeping and Independence 383

parental presence). Additional research is needed to: uncover the means by


which children learn to go to sleep and return to sleep independently; evaluate
parental satisfaction with the method used (especially techniques that involve
prolonged crying), and see whether a particular method is especially satisfactory
for children who had been used to co-sleeping.
Unlike sleep-related behaviours, age at toilet training was unrelated to sleep
arrangements, perhaps because current pediatric advice suggests supporting the
childs lead in the toilet training process (e.g. Brazelton, 1992). Parents in all sleep
groups might have been heeding experts advice to let the child make his or her
own decisions regarding readiness for toilet training, as children in this sample
toilet trained roughly at the same age.
An interesting and unexpected finding was that early co-sleeping children, as
preschoolers, were reported by their mothers to be more self-reliant and
reportedly exhibited greater social independence (e.g. ability to dress oneself,
work out problems with playmates by oneself) than either solitary sleeping
children or reactive co-sleeping children. Maternal autonomy support did not
mediate this finding. Perhaps, as claimed by proponents of co-sleeping and in
accord with predictions from attachment theory (Ainsworth et al., 1978; Bowlby,
1969; Sroufe et al., 1983), increased emotional security early on promotes
independence as the child becomes older. Longitudinal studies are needed to
examine links between sleeping arrangements, felt security, and independence in
non-sleep domains. Future studies also should include direct, observation-based
assessments of infant-parent attachment and childhood independence.
According to Deci, Ryan, and colleagues, parents who support their childrens
autonomy encourage childrens regulation of their own behaviour, self-initiation,
choice, responsibility, independent problem solving, and participation in
decision-making (Grolnick and Ryan, 1989; Ryan and Deci, 2000; Ryan et al.,
1995). As expected, early co-sleeping mothers were more likely than other
mothers to support their childrens autonomy and be less controlling. It is
possible that mothers of early co-sleepers are compensating for dependence at
night with increased opportunities for autonomy during the day, a strategy
suggested by Brazelton (1992). Viewed another way, maternal autonomy support
during the day may follow a parenting style that lets the child take the lead on
sleep-related routines and behaviours at night, often with some guidance from
the parents. In other words, allowing the child a choice about where to sleep is
consistent with a parenting style that encourages a childs autonomy (i.e.
participation in decision-making and responsibility for his or her own
behaviour). In families where sleep routines for toddlers and preschoolers are
set by parents, it may be important to offer children opportunities for autonomy
and decision-making in areas other than sleep, if this is consistent with parenting
values. A promising avenue for future research would further address these
connections among sleep arrangements, parenting values and styles, child-
rearing practices, and parents developmental goals for their children.
Despite the relevance of these findings for practice and future research, this
study does have several limitations. Generalizability is limited due to the largely
middle- to upper-middle-class sample that participated. The number of
respondents from Asian and other ethnic backgrounds did not permit full
analysis of cultural differences. The lack of significant ethnic differences in this
study (see footnote 1) may stem from low statistical power; it also suggests the
need to examine acculturation factors when including an ethnically diverse
sample. This study also is limited by the difficulties inherent in single-source,
self-report measures and the partially retrospective nature of some of the data.

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384 M.A. Keller and W.A. Goldberg

Although maternal reports of infant sleep behaviour may not always be


consistent with observational recordings of infant sleep (Minde et al., 1993),
maternal reports (either interviews or surveys) are used in most major studies in
this field (Abbott, 1992; Ball et al., 1999, 2000; Caudill and Plath, 1966; Crowell
et al., 1987; Hayes et al., 1996; Lee, 1992; Lozoff et al., 1984, 1986; Madansky and
Edelbrock, 1990; Morrell and Cortina-Borja, 2002; Morelli et al., 1992) and are
particularly relevant when the researcher is interested in whether mothers
perceive childrens sleep behaviours to be disruptive or not.

Implications for Practice


The results of this study should help inform practitioners knowledge about sub-
types of co-sleeping and help guide clinicians as they obtain detailed histories
about sleep arrangements and parental attitudes toward these arrangements. A
major finding of the study, that reactive co-sleepers differ from early co-sleepers
in that their co-sleeping is often beset with problems, suggests that parents of
reactive co-sleepers require the most guidance to reconcile their attitudes and
behaviours. The reactive co-sleeping group appears to consist of a mixture of
families: parents who may have difficulty setting limits with their children and
are locked in a nightly bedtime power struggle (Ferber, 1985b), parents who enjoy
the physical and emotional connections or find co-sleeping simply to be a
convenient and efficient means of resettling their child in the middle of the night,
and parents who feel uncomfortable with the back-to-sleep or fall-to-sleep-
alone plans offered in some parenting guides (e.g. Brazelton, 1992; Ferber, 1985b;
Mindell, 1997; Spock, 1988, 2001; Weissbluth, 1987). It may be helpful for reactive
co-sleeping mothers either to get support to feel more comfortable with the
practice of co-sleeping or get assistance with developing solitary sleep
arrangements so that they get relief from an unsatisfactory routine. Practitioners
can discuss various sleep training methods for infants and older children if the
idea and practice of co-sleeping are not desired by the parent (Lozoff et al., 1996).
It is also important to remember that the existence of sleep problems does not
mean they cannot be solved (McKenna, 2000) or will go on indefinitely, nor do we
know without further research what correlates exist between early childhood
sleep arrangements and adulthood sleep problems and habits.
As we found, families of early co-sleepers should be aware that their children
may take longer to learn self-sleeping habits than if their children slept
separately; these parents need to feel comfortable with the idea of remaining
with their toddler or preschool child when he or she falls asleep at bedtime or
wakes up during the night (Lozoff et al., 1996). Practitioners also can inform new
parents that an early co-sleeping arrangement seems to be associated with
childrens independence and autonomy in non-sleep domains during the
preschool years.
As pediatric experts who once disavowed co-sleeping are becoming more open
to cultural variation in sleep arrangements and more accepting of co-sleeping as a
viable alternative (Brazelton, 1992; Spock, 1988, 2001; Stein et al., 1997), this
acceptance should be communicated to new co-sleeping parents who may be
struggling with disapproval from other family members or the community at
large. Clinicians need to be aware of culturally diverse child-care goals and
discuss with parents the advantages and disadvantages of sleep arrangements as
families weigh medical and social factors to formulate their choices (McKenna,
2000).

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Co-Sleeping and Independence 385

It is worthwhile taxonomically to note that sleep arrangements occur on a


continuum of proximity (McKenna and Mosko, 2001). Co-sleeping could be
presented to parents in a broader framework to include room-sharing, a practice
that would have parent and infant within sensory range of each other, able to
communicate through at least two modalities (McKenna and Mosko, 2001). Based
on the results of a large, population-based, case-control study of SIDS in Great
Britain, room-sharing was not associated with increased risk of SIDS whereas
sleeping in a separate room and unsafe bedsharing practices did bring greater
risk (Blair et al., 1999).
Importantly, parents should be advised to take safety precautions when co-
sleeping and steer clear of hazardous sleeping environments and conditions.
Parents who bedshare should use a firm mattress, eschew waterbeds and
sofas as sleep surfaces, avoid placing the infant under duvets, and should not
smoke or be under the influence of alcohol or drugs when in bed with
their child (Blair et al., 1999; Gordon and Goodavage, 2002; Jackson,
1999; McKenna, 2000; Sears, 1987; Sears and Sears, 1993; Spock, 2001; Thevenin,
1987).
Clearly, not all children and parents are the same and what works in one family
will not necessarily work for others in the same way for the same reasons. By
obtaining parental reasons for, and reactions to, various sleep arrangements,
clinicians can help families match childrens needs and parenting values with
preferred child-rearing practices.

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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