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Intervention studies


Early childhood insomnia: Underlying mechanisms of intervention effects of the “bedtime checking” and the “standard checking” methods


Early-childhood insomnia is very prevalent and is associated with negative child and family outcomes. Behavioral interventions, based on limiting parent-child nocturnal interactions, are effective in significantly improving infant sleep. Yet, these interventions frequently involve significant parent and infant distress that deter many parents. Research on sleep interventions that involve a lower “dose” of parent-infant separation, and thus may be more acceptable to many parents, has so far been sparse. Also, little scientific attention has been paid to factors that may underlie parental compliance with behavioral sleep interventions and treatment outcomes. Thus, using a randomized control design, the main aim of our study is to investigate the processes through which parent-infant factors (e.g., parental sleep-related cognitions, stress, guilt, couple support, infant temperament) impact treatment adherence and outcomes of an intervention that involves parent-infant separation only at bedtime (i.e., low “dose” of separation; “bedtime checking”), compared to a method that also targets night-wakings (“standard checking”).

This project is supported by the Israel Science Foundation (grant number 1101/22).

Longitudinal studies


Parental sleep, infant sleep and the parent-infant relationship:

A transactional perspective

In this 5-year longitudinal study we investigated the links between parental (both mothers and fathers) sleep in the first year post-partum and the parent-infant relationship. While maternal risk factors, such as depression, have been extensively studied in relation to compromised mother-infant relationship, the role of parental sleep disturbances has been almost entirely ignored in the context of caregiving behavior. This is surprising because parents' sleep in the post-partum period is often chronically disturbed, and it has been well established that disturbed sleep has significant negative implications for individuals' functioning.


Our study included about 230 two-parent families and about 130 solo-mother families (i.e., mothers who decided to parent alone) who were assessed during pregnancy and at 4, 8, and 12 months post- partum. Parents' (both mothers’ and fathers’) and infant sleep was assessed by actigraphy, sleep diaries and questionnaires. The parent-infant relationship was assessed by questionnaires and the mother-infant relationship was also assessed by direct observations, using the Emotional Availability Scale.

  • Our findings demonstrate that, across the different assessments, maternal objective and self-reported sleep quality were poorer than paternal sleep and were more strongly associated with infant sleep. However, fathers’ sleep also undergoes significant changes following the arrival of the infant, suggesting that it should be given full attention.

  • As part of this study we employed a diary-study design and examined, for the first time, whether nightly fluctuations in maternal sleep quality explain day-to-day disruptions in the mother-infant relationship. Our analyses revealed that when a mother had lower objective and subjective sleep quality on a given night, she reported lower levels of patience for her infant and more anger on the following day.

  • The inclusion of solo-mother families in our study comes from the fact that this unique family structure is steadily growing but has almost not been explored. Our findings revealed only small differences in sleep quality between two-parent families and solo-mother families, suggesting that sleep quality in solo mother families, does not seem to be significantly affected by the absence of a second parent.

​Publications based on this study include:


This project was supported by the Israel Science Foundation (grant number 345/15).



Maternal emotional distress and infant sleep problems:

A longitudinal study of underlying mechanisms

This longitudinal study examined the links between maternal emotional distress and infant sleep development during the first 18 months of life. As part of this study we also collected data about maternal sleep, sleeping arrangements and parenting factors such as paternal involvement in caregiving. The sample included about 220 families that were assessed during pregnancy and at 3, 6, 12 and 18 months postpartum. Both maternal and infant sleep were assessed by actigraphy, sleep diaries and questionnaires. 

Publications based on this project include:

  • Tikotzky, L., Sadeh, A., Volkovich, E., Manber, R., Meiri, G., & Shahar, G. (2015). Infant sleep development from 3 to 6 months postpartum: Links with maternal sleep and paternal involvement.  "Monographs of the Society for Research in Child Development (SRCD), 80, 107-124.

  • Volkovich, E., Ben-Zion, H., Karny, D.S, Meiri, G. & Tikotzky, L. (2015). Sleep patterns of co-sleeping and solitary sleeping infants and mothers: a longitudinal study, Sleep Medicine, 16, 1305-1312

  • Volkovich, E., Tikotzky, L. & Manber, R. (2016). Objective and subjective sleep during pregnancy: links with depressive and anxiety symptoms. Archives of Women's Mental Health, 1, 173-181.

  • Volkovich, E., Bar-Kalifa, E., Meiri, G., & Tikotzky , L. (2018). Mother-infant sleep patterns and parental functioning of room-sharing and solitary sleeping families: a longitudinal study from 3 to 18 months. Sleep, 41, 1-14. (Editor’s choice).

  • Kahn, M., Bauminger, Y., Volkovich, E., Meiri, G., Sadeh, A.,, & TikotzkyI, L.  (2018). Links between infant sleep and parental tolerance for infant crying: Longitudinal assessment from pregnancy through 6-months postpartum. Sleep Medicine.

  • Tikotzky, L., & Volkovich, E. (2019). Infant nocturnal wakefulness: a longitudinal study comparing three sleep assessment methods. Sleep, 42 (1), 1-12.

  • Gueron-Sela., N, Schahar, G., Volkovich., E., & Tikotzky, L. (2021). Prenatal maternal sleep and trajectories of postpartum depression and anxiety symptoms. Journal of Sleep Research, 30.

  • Tikotzky, L., Volkovich, E., & Meiri, G. (2021). Maternal emotional distress and infant sleep: A longitudinal study from pregnancy through 18 months.  Developmental Psychology, 57 (7), 1111.

  • Tikotzky, L., Bar-Shachar, Y., Volkovich, E., Meiri, G., & Bar-Kalifa, A. (2022). A longitudinal study of the links between maternal and infant nocturnal wakefulness. Sleep Health, 8 (1), 31-38.


This research was supported by the Israel Science Foundation (grant number 1075/10).

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