Self-Efficacy Buffers Effects of Infant Sleep on Maternal Mental Health Outcomes

Maternal self-efficacy (MSE) moderates the impact of infant sleep quality on maternal mental health, reducing depression, anxiety, stress, and sleep problems, and enhancing happiness, but not life satisfaction, according to study results published in Behavioral Sleep Medicine.

Researchers conducted a cross-sectional online survey from October 2021 to January 2022 among Iranian mothers of infants and toddlers aged 0 to 36 months. They examined how MSE moderates the relationship between infant sleep quality and maternal mental health outcomes—including depression, anxiety, stress, sleep problems—as well as life satisfaction and subjective happiness. Participants completed validated Persian versions of six questionnaires measuring infant sleep (BISQ-R), maternal self-efficacy (MSES), depression, anxiety, and stress (DASS-21), maternal sleep problems (PSQI), life satisfaction (SWLS), and happiness (SHS).

Among 544 mothers of infants and toddlers, most children were firstborn (67.65%), male (53.49%), and between 24 and 36 months old (30.88%). Mothers had a mean (SD) age of 32.27 years (4.29), with 86.95% holding undergraduate or postgraduate degrees, though 68.2% were not employed full- or part-time. The mean infant sleep score was 59.09 (15.77), and mothers reported moderate self-efficacy (M = 33.47, SD = 5.27).

Correlation analysis revealed that better infant sleep was positively associated with maternal self-efficacy (r=.173, P <.01), happiness (r=.175, P <.01), and life satisfaction (r=.160, P <.01), and negatively correlated with maternal depression (r=–.140, P <.01), anxiety (r=–.164, P <.01), stress (r=–.144, P <.01), and sleep problems (r=–.281, P <.01). Maternal self-efficacy was strongly correlated with lower depression (r=–.360, P <.01), anxiety (r=–.285, P <.01), and stress (r=–.309, P <.01), and positively with happiness (r=.356, P <.01) and life satisfaction (r=.260, P <.01).

Moderation analyses showed that maternal self-efficacy significantly buffered the impact of infant sleep on maternal outcomes. Specifically, MSE moderated associations between infant sleep and depression (B=–.007, P =.009), anxiety (B=–.006, P =.010), stress (B=–.008, P =.005), sleep problems (B = –.008, P =.003), and happiness (B=.011, P =.001), but not life satisfaction (P =.199). Conditional effects showed that mothers with high self-efficacy experienced fewer anxiety (B=–.063, P <.01), stress (B=–.081, P <.01), and sleep problems (B=–.128, P <.01) as well as fewer depressive symptoms (B=–.062, P <.01) when their infants had better sleep. Conversely, mothers with low self-efficacy showed minimal benefit from good infant sleep, particularly in measures of emotional distress.

The study authors concluded, “Interventions informed by Social Cognitive Theory and aimed at enhancing maternal self-efficacy hold promise in promoting positive maternal mental health outcomes and overall well-being.”

Study limitations include the cross-sectional design, potential biases due to self-reported sleep measures, and the online recruitment approach which may not represent the general population.

This article originally appeared on Psychiatry Advisor