Cosleeping Arrangements

Cosleeping is generally characterized by caregivers and their children sleeping in close proximity, either with the caregiver and child sharing a bed or the child sleeping in the same room as the caregiver but in a separate location, such as a bassinet or crib. Cosleeping can entail children and caregivers sharing sleeping locations for all or part of a night for all or just some nights.

Cosleeping has been identified as the predominant sleeping pattern for families across the world. Despite this widespread use of cosleeping, questions concerning potentially negative outcomes associated with cosleeping abound, particularly in the United States and other Western-based cultures. Negative outcomes have focused on the likelihood of increased night wakings for cosleeping infants in comparison with infants who sleep separately from caregivers and soothe themselves back to sleep upon waking.

A review of what is known regarding children’s sleep suggests that night wakings and needs for parental  attention  are  normative  across  all  sleep types, recede over the course of development, and may not be problematic for cosleeping families. For example, the night wakings associated with cosleeping infants are identified as problematic by families engaged in reactive cosleeping (i.e., cosleeping in response to infant sleep problems), but not by families engaged in cosleeping by choice. Furthermore, reports of sleep problems associated with cosleeping arrangements tend to vary based on families’ cultural backgrounds, children’s or mothers’ temperament, or other environmental factors and thus may reflect questions of caregivers’ expectations for sleep and socialization goals.

Physiologically, cosleeping leads to lighter infant sleep, in comparison with solitary sleeping patterns characterized by greater periods of quiet sleep. During cosleeping, infants’ and caregivers’ breathing patterns and sleep cycles become synchronous. These physiological characteristics of cosleeping children, as well as the higher level of parental monitoring associated with cosleeping, may guard against sudden infant death episodes, which can occur when infants fail to continue breathing during sleep.

In regard to social development, caregivers’ attention to infants’ waking during the sleep routine may help to build a strong attachment between caregiver and infant and thus help form the basis for children’s development of a secure attachment and the associated positive social outcomes. In addition, cosleeping may contribute to the likelihood of breast-feeding, which is associated with psychological and health benefits for  infants.  Despite  these  potential  benefits,  some concerns have been raised that cosleeping, in comparison with solitary sleeping arrangements, may compromise children’s development of independence and children’s ability  to  separate  from  parents.  Empirical  support can be found for positive social outcomes associated with both cosleeping and solitary sleeping arrangements. Furthermore, a preliminary research report has associated children’s positive social development with caregivers’ comfort with their chosen sleeping arrangements, but not caregivers’ and infants’ engagement in one specific type of sleeping pattern.

Cosleeping has been cited as putting infants at risk for suffocation by overlaying or wedging between the caregiver and bedding. In light of these concerns, solitary sleeping arrangements have been identified as safer for infants and often proposed as the preferred sleeping arrangement. However, some research studies report that cosleeping is not more risky unless caregivers smoke cigarettes, are overweight or overly fatigued, use soft bedding, sleep in arrangements where infants became overheated, or use drugs or alcohol.

Given the varied outcomes associated with cosleeping and other types of sleep patterns, and given the universal acceptance of cosleeping, this sleeping pattern represents a viable and important sleep option for parents and professionals to consider when addressing infant and toddler sleep needs. The viability of cosleeping as a sleep option is further supported in that neither cosleeping nor other types of sleep arrangements have been associated with definitively fewer sleep problems for infants or toddlers or with better sleep habits at later developmental stages.

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