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

Objective: Investigate racial and ethnic differences in infant sleep and examine associations with insurance status and parent-infant bedtime behavioral factors (PIBBF). Methods: Participants are part of the COVID-19 Mother Baby Outcomes (COMBO) Initiative, Columbia Univer-sity. Data on infant sleep (night, day and overall sleep duration, night awakenings, latency, infant's sleep as a problem) were collected at 4 months postpartum. Regressions estimated associations between race/ethnic-ity, insurance status, PIBBF and infants' sleep. Results: A total of 296 infants were eligible (34.4% non-Hispanic White [NHW], 10.1% Black/African American [B/AA], 55.4% Hispanic). B/AA and Hispanic mothers were more likely to have Medicaid, bed/room-share, and report later infant bedtime compared to NHW mothers. Infants of B/AA mothers had longer sleep latency compared to NHW. Infants of Hispanic mothers slept less at night (-70 +/- 12 minutes) and more during the day (-41 +/- 12 minutes) and Hispanic mothers were less likely to consider infants' sleep as a problem com-pared to NHW (odds ratio 0.4; 95% confidence interval: 0.2-0.7). After adjustment for insurance status and PIBBF, differences by race/ethnicity for night and day sleep duration and perception of infant's sleep as a problem persisted (-32 +/- 14 minutes, 35 +/- 15 minutes, and odds ratio 0.4; 95% confidence interval: 0.2-0.8 respectively). Later bedtime was associated with less sleep at night (-21 +/- 4 minutes) and overall (-17 +/- 5 minutes), and longer latency. Infants who did not fall asleep independently had longer sleep latency, and co -sleeping infants had more night awakenings. Conclusions: Results show racial/ethnic differences in sleep in 4-month-old infants across sleep domains. The findings of our study suggest that PIBBF have an essential role in healthy infant sleep, but they may not be equitably experienced across racial/ethnic groups.(c) 2022 National Sleep Foundation. Published by Elsevier Inc. All rights reserved.