Evidence map›Paper›PMID 40962332›Full record

ArticlePediatrics2025

Changes in Sleep Practices During and After Illness.

Mary Beth Howard, Leticia M Ryan, Kevin J Psoter, Barry S Solomon, Milind Mutala, Sarah Ehrenberg, Rachel Moon

Registry-linked trialAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Pediatrics, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07779512 (A Pediatric Emergency Department-based Intervention to Increase Infant Adherence to Safe Sleep Practices), which is not on this map. Not yet cited in PubMed.

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0cells of the map it votes in
0citing papers in PubMed
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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT07779512 nanot yet recruitingnot on this mapstarted 2026, after this paper: background citation

A Pediatric Emergency Department-based Intervention to Increase Infant Adherence to Safe Sleep Practices

TypeinterventionalSponsorState University of New York at BuffaloRan2026 to 2027Enrolled214ConditionsInfant Safe Sleep Practices, SIDSArmsSafe Sleep Education, Behavior habit tracking
3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Mary Beth HowardDivision of Pediatric Emergency Medicine, Department of Pediatrics, Johns Hopkins University, Baltimore, Maryland.
Leticia M RyanDivision of Pediatric Emergency Medicine, Department of Pediatrics, Johns Hopkins University, Baltimore, Maryland.
Kevin J PsoterDivision of General Pediatrics, Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Maryland.
Barry S SolomonJohns Hopkins Bloomberg School of Public Health, Center for Injury Research and Policy, Johns Hopkins University, Baltimore, Maryland.
Milind MutalaKrieger School of Arts and Science, Johns Hopkins University, Baltimore, Maryland.
Sarah EhrenbergDepartment of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Maryland.
Rachel MoonDepartment of Pediatrics, University of Virginia, Charlottesville, Virginia.

Funding

Institutional Career Development CoreKL2TR003099 · NCATS · JOHNS HOPKINS UNIVERSITY · PI GEBO, KELLY A · 2019 to 2023
$7.9M
NCATS NIH HHS KL2 TR003099
6 · The paper itself

Abstract

objectivesUnsafe sleep practices contribute to sleep-related infant mortality. Recent infant illness is a risk factor for sudden unexplained infant death. This study examined changes to safe sleep practices during and after infant illness.

methodsWe performed a prospective cohort survey study of caregivers of infants (aged 0-12 months) presenting to the pediatric emergency department (ED) for illness. Surveys assessed sleep practices before, during, and after illness (2-week and 1-month follow-ups). We assessed adherence to the American Academy of Pediatrics (AAP) safe sleep recommendations at each time point. Differences in adherence were evaluated using mixed-effects logistic regression, whereas Poisson regression was used to evaluate the change in number of safe sleep practices for selected participant characteristics.

resultsOf 131 enrolled participants, 106 (81%) completed all follow-up surveys. Adherence to AAP recommendations was low (<10%) across all time points but decreased during illness without a significant change following illness. Bed-sharing increased from 57.3% pre-illness to 68.7% during illness (P = .032) and remained elevated at the 1-month follow-up (83.6%). Sleeping in a crib or pack n' play decreased from 61.8% pre-illness to 48.1% during illness (P = .005) and remained low at follow-up. Caregiver motivations changed during illness, with fewer citing safety (46.6% vs 42.0%) and more being influenced by family recommendations (5.3% vs 15.3%).

conclusionsCaregivers of infants presenting to the ED for low acuity illness report low adherence to safe sleep practices, which worsened during and after illness. Future studies should explore targeted, illness-specific anticipatory guidance to reinforce safe sleep practices during and after illness.

Indexed as

SleepSudden Infant DeathAdultCaregiversCohort StudiesEmergency Service, HospitalFemaleFollow-Up StudiesGuideline AdherenceHumansInfantInfant, NewbornMaleProspective StudiesSurveys and Questionnaires

Identifiers

PMID40962332
PMCPMC12643614

What OpenQuestion holds

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.