Assessing infant sleep quality and arousals: comparison of wearable data with parent perspectives

Background Infant sleep is vital for development, yet current assessments rely on subjective parental reports, underscoring the need for more reliable, objective methods. Methods A total of 104 infants (424 nights) were measured at home using a novel NAPping PAnts (NAPPA) wearable, with arousals detected across a wide range of duration criteria. Parental sleep diaries were collected to capture perceived sleep quality (pSQ), reported arousals, and whether the infant slept in a shared or separate room. Diary data were used to study correlations with NAPPA-measured infant arousals, and regression models assessed the relationship between pSQ and reported versus measured arousals. Results The pSQ correlated moderately with both the reported (ρ = −0.47, p < 0.001) and NAPPA-measured (ρ = −0.40, p < 0.001) arousals. The number of reported arousals was most comparable with the NAPPA-measured arousals in the 3–5-min duration range. However, parents significantly underestimated shorter arousals and overestimated longer ones, especially in a shared room with parents. Conclusion Direct infant measurements with the NAPPA wearable revealed a substantial difference between directly measured and parentally reported arousals. The findings suggest that infant sleep studies should incorporate direct and objective infant measurements, now made feasible and scalable through novel at-home wearable methods. Impact Infant sleep assessments typically rely on parent’s subjective reports rather than objective measurements of the infant’s sleep. This study addresses a critical gap by comparing parental reports of infant sleep with high-resolution, objective measurements from the novel NAPPA (NAPping PAnts) wearable, demonstrating its feasibility for at-home use. Specifically, we show that parentally reported nighttime events, such as sleep quality or infant arousals, only partially reflect the infant’s actual sleeping behaviour. Our findings highlight the importance of measuring infant sleep objectively, and the novel methodology opens new research avenues that may guide sleep health interventions.