Sleep disorders in the first 18 months of life: Hypothesis on the role of mother-child emotional exchanges

Sleep disturbances of infancy (troubles in falling asleep, in the duration of sleep, night waking) are now the subject of renewed interest. Recently, these sleep problems in babies and young children seem to have increased in frequency and severity. A pilot study of sleep disorders is underway at the child department of the Hopital de la Poterne des Peupliers and involves more than 80 children aged 0–18 months. Twenty-nine infants have been selected from this cohort with severe and persistent sleep disorders that began in the first 18 months of life. In the absence of a control group, all cases were selected carefully. Some of the characteristics of these children are discussed: Age, sex, associated troubles, modalities of soothing, effect of hypnotic drugs, development under treatment. Some of these children are noted to be very active. Quite often, the pregnancy was marked by a traumatic event or by depression or anxiety in the mother. During evaluation of the mother-child interaction, one often notes a withdrawal of the mother's cathexis toward her child, which can go along with hyperstimulation in the relationship. This withdrawal concerns the emotional and fantasied dimensions of the interaction. The child's reactions and initiatives can be paralleled with the mother's speech, motor, and emotional attitudes. Thus, sleep disorders in early childhood represent an opportunity to observe the modalities of emotional exchange between mother and child and a methodologically interesting situation for the assessment of mother-child relationships.