Category: Sleep / Wake Disorders

PS3- #C85 - Impact of Parental Differences in Accommodation on Sleep-Related Problems in Children

Friday, Nov 17
11:00 AM – 12:00 PM
Location: Indigo Ballroom CDGH, Level 2, Indigo Level

Keywords: Sleep | Parent Training | Child Anxiety

Sleep-related problems (SRPs), non-developmentally appropriate sleep patterns, have detrimental effects on mental and physical health. Children with anxiety may be especially sensitive to parental accommodations that reinforce SRPs, such as delaying bedtime or co-sleeping with parents. Parental accommodation is a potential underlying mechanism of SRPs, but research has yet to examine ways co-parents differ in rates/types of accommodation, which could have important implications for parent training (e.g., importance of involving both parents, differential training depending on type of accommodations).


This study reports on data from the Family Accommodation Checklist and Interference Scale (FACLIS), Family Accommodation Scale-Anxiety (FASA), and Child’s Sleep Habits Questionnaire (CSHQ), completed by treatment-seeking parents of anxious youth presenting for outpatient treatment.  Data for this study were collected from a sample of 112 children ages 3 to 17 (M=11.2), 54% female, and majority Caucasian (88%).  The majority of participants had SRPs at a clinical level according to mother (63%) and/or father (58%) report. 


Children with clinical SRPs received significantly more sleep accommodation than those with subclinical SRPs according to mother (t(1,109)=-3.38, p=.001) and father (t(1,70)=-4.09, p ≤ .001) report.  Fathers of children with clinical SRPs reported significantly more interference from sleep accommodation than fathers of children with subclinical SRPs (t(1,35)=-4.66, p ≤ .001). There was no significant difference in interference for mothers. Children with clinical SRPs received significantly more non-sleep accommodation than children with subclinical SRPs only according to mother report (t(1, 98)=-2.91, p ≤ .01).  Hierarchical regression was run to predict sleep disturbance with demographics (gender, age) in the first step, anxiety in the second step (MASC score), general accommodation in the third step (non-sleep FACLIS, FASA), and sleep accommodation in the final step (sleep FACLIS).  For mother report the final model was significant (F(6,62)=4.34, p=.001), and explained 30% of the variance in CSHQ score. Sleep accommodation was the only significant predictor variable in this model (β = .44, p = .001). For father report the final model was significant (F(6,41)=2.64, p=.03), and explained 28% of the variance in CSHQ score. Sleep accommodation was the only significant predictor variable in this model (β = .36, p = .03).


This study provides support for the hypothesis that higher levels of sleep accommodation are associated with greater sleep disturbance, suggesting that sleep accommodation may be contributing to maintenance of SRPs through reinforcement.  This study also suggests parental differences in accommodation: mothers reported more non-sleep accommodation and fathers reported more accommodation interference for children with clinical SRPs.  These findings have treatment implications as mothers may benefit from general training around reducing accommodation and fathers may need support in reducing interference. Future research will examine causal links between these constructs and how addressing them can improve the treatment of SRPs in children with anxiety.

Lydia L. Chevalier

Graduate Student
Boston University
Boston, Massachusetts

Erin E. O'Connor

Graduate Student
Boston University
Brookline, Massachusetts

Lindsay E. Holly

Postdoctoral Associate
Boston University
Boston, Massachusetts

David Langer

Research Assistant Professor
Boston University
Boston, Massachusetts

Donna Pincus

Associate Professor, Department of Psychological and Brain Sciences
Boston University
Boston, Massachusetts