Baby-Lag: Methods for assessing parental tiredness and fatigue

Abstract

Altered sleep patterns, inadequate sleep, and fatigue are extremely common among new parents and form a major part of postpartum life. The first months of a new infant’s life are a time of extensive adjustment for families, and the experience of new parenthood is often colored by sleep deprivation and chronic tiredness—what has popularly been termed ‘Baby-Lag’. Studies of stress, depression, anxiety, and measures of parenting function and behaviors would all benefit from the inclusion of information about parental tiredness and fatigue. However, the measurement of states of tiredness and fatigue is complex and inconsistent. In this chapter, we review existing ‘etic’, or externally generated, methods that measure fatigue and tiredness, and assess their relevance and feasibility for use with new parents. Objective measures including polysomnography, actigraphy, and psychomotor vigilance tests have been widely used in the clinical arena. Subjective measures in which respondents rate their sleep within a given period, report on some aspects of sleep, or give details of their sleep ecology have been used in clinical populations and extended into community studies. We are not aware of sleep evaluations that successfully measure the invisible experience of parental sleep loss in the postpartum period from an internal or ‘emic’ perspective. The final section of the chapter presents narrative data from focus groups of mothers caring for infants under a year old. We propose the need for a novel instrument to capture key elements of the Baby-Lag phenomenon and offer suggestions for the development of such a tool.