Institute for Continuing Education

Cultural Influences on Infant Sleep

Course Objectives

Upon successful completion of this module, you will be able to:

• Analyze the concept of "normal" infant sleep across cultural contexts, recognizing that sleep patterns, practices, and developmental expectations vary substantially across societies based on cultural values, parenting philosophies, environmental factors, and socioeconomic conditions rather than representing universal biological imperatives.
• Evaluate the historical development of cross-cultural sleep research, including the pioneering work of anthropologists such as Carol Worthman, James McKenna, and others who documented cultural variations in infant sleep arrangements, the timing of this research emergence in the 1990s-2000s, and how this work challenged Western-centric assumptions about "normal" sleep development.
• Synthesize the bidirectional relationship between cultural ideologies (independence vs. interdependence, individualism vs. collectivism) and infant sleep practices (solitary vs. co-sleeping, scheduled vs. demand-responsive feeding, sleep training approaches), understanding how cultural values shape parenting goals which in turn influence sleep arrangements and expectations for developmental outcomes.
• Compare and contrast Western biomedical models of "healthy, normal" infant sleep (emphasis on consolidated nighttime sleep, self-soothing, independent sleep location, scheduled routines) with practices and expectations in non-Western cultures (acceptance of nighttime waking, responsive nighttime parenting, bed-sharing, extended breastfeeding), recognizing the cultural construction of sleep norms.
• Apply culturally sensitive clinical approaches when working with diverse families in sleep medicine settings, including conducting culturally informed sleep histories, recognizing when "sleep problems" reflect cultural norm mismatches rather than pathology, providing evidence-based information while respecting cultural practices, and identifying true sleep disorders requiring intervention.
• Assess the evidence regarding safety and outcomes of various infant sleep practices including bed-sharing/co-sleeping, room-sharing, solitary sleep, sleep training methods, and feeding practices, understanding how risk factors, protective factors, and cultural contexts modify outcomes and how to provide nuanced, culturally appropriate guidance.
• Explain the implications of cultural diversity in infant sleep for sleep technologists and pediatric sleep medicine, including recognition of normal developmental variations, avoidance of ethnocentric bias in clinical assessment, understanding of culturally-based parent concerns, and provision of family-centered care that respects cultural values while ensuring infant safety and health.

Course Information

"...we try to keep in mind cultural influences on the advice we give. We remind ourselves that much of what comes to the pediatrician’s attention, as problematic sleep behavior--children who have difficulty falling asleep alone at bedtime, who wake at night and ask for parental attention, or who continue to nurse at night--is problematic only in relation to our society’s expectations, rather than to some more general standard of what constitutes difficult behavior in the young child. Our pediatric advice on transitional objects, breast feeding, co-sleeping may be unknowingly biased toward traditional Euroamerican views of childrearing, especially those about bedtime and nighttime behavior. Thus, in giving advice about sleep, pediatric health professionals might do well to be aware of their own cultural values, to examine closely their patients cultural and family contexts, and to assess parental reactions to children’s sleep behaviors" (1).