Longitudinal examination of the impact of maternal insomnia on offspring social-emotional outcomes

About This Grant

PROJECT SUMMARY/ABSTRACT Poor social-emotional development in early childhood is associated with negative short- and long-term outcomes, such as childhood psychopathology, poor school achievement, and economic consequences for families and society. Therefore, improving social-emotional development during early life may prevent adverse outcomes for children and families. Insomnia experienced by mothers during pregnancy or the postpartum period (i.e., perinatal insomnia) is a common, modifiable, and promising risk factor for poor social-emotional development in offspring, but extant observational data preclude causal inference. The current proposal capitalizes on the unique, cost-effective opportunity to follow an established cohort of mother-offspring dyads in order to provide causal evidence of whether and how an insomnia intervention delivered during pregnancy promotes offspring social-emotional development in humans. Specifically, the current proposal leverages the ongoing NIMH-funded PRISM Study. Participants are pregnant people with insomnia disorder (target N=498), randomized to a digital intervention proven effective for improving perinatal insomnia (cognitive behavioral therapy for insomnia) or to a clinically relevant but inert control condition (sleep hygiene education) and followed through one year postpartum. The proposed Growing Offspring Wellness Study (GROW Study) will follow the PRISM Study mother-offspring dyads longitudinally from ages 2-4 years to investigate a distinct, non-overlapping set of aims. Specifically, the PRISM Study provides the experimental manipulation required to achieve the following GROW Study aims: 1) Examine the impact of an efficacious perinatal insomnia intervention on offspring social-emotional outcomes measured via maternal report and objectively coded behavioral observation; and 2) Investigate postpartum depression and observed parenting behavior as potential mediators. If successful, the proposed project will show that a scalable, effective insomnia intervention delivered to mothers during pregnancy improves the social-emotional outcomes of their offspring. Findings regarding mediators may assist with intervention refinement to further amplify the impact on offspring social-emotional outcomes. Improving social-emotional outcomes in early life has high public health significance considering the high individual, familial, and societal costs of poor social-emotional outcomes and their sequelae.