Cosleeping among child and adolescent in psychiatric consultation

Objective. - The aim of our study is to determine the socio-demographic and clinical characteristics of Tunisian children and parents who cosleep. Method. - A descriptive and prospective study was conducted between July and November 2017 in the Child Psychiatric Department at Mongi Slim Hospital (Tunisia). We included all new patients who, or whose parents, reported a cosleeping. Cosleeping was defined as the practice of parent and child sharing a sleeping surface that includes room-sharing or bed-sharing. Socio-demographic and clinical data were collected from medical files, namely: age, sex, somatic personal history, rank in the siblings, and the psychiatric diagnosis according to fifth edition of the Diagnostic and Statistical Manual of Mental Disorders criteria. Information on parents' marital status, educational attainment and personal history were noted. An hetero-questionnaire for the parent(s) explored the modalities of cosleeping: the beginning of this practice, the place: bed or room, the person sharing the sleep, the existence or not of sleep disorders. In case of bed-sharing, physical proximity between parent and child has been classified, subjectively, as: absent, close and very close. So when the child slept holding the hand or any other part of his parent's body but not on the same pillow as him, the contact was considered close. Sleeping on the same pillow, or sleeping in his parent's arm was considered a very close contact. Results. - 70 patients were included. There were more boys (63%, n = 44) than girls (37%, n = 26). The prevalence of cosleeping was 17%. The median age was at 6, 82 years with extremes between 2 and 16 years. Benjamin were widely represented in our population (49%, n = 34), while ten were the only child of their families. Thirty-seven of them have personal history of somatic disease. Autism Spectrum Disorder and Separation Anxiety Disorder were the two most common diagnoses respectively in fourteen cases and nine cases. Early mother-infant interactions were considered good in 37 mother-child dyads while they were limited to purely "mechanical" exchanges in the remaining 33. Sleep sharing existed since birth in 57% of cases. For the rest of the children (n = 13), cosleeping started after a remarkable event (road accident, physical violence, separation of parents, parasomnias...) Psychiatric follow-up was reported in 16% of mothers and 7% of fathers. 46% of families have an average socio-economic level while 24% have a go