A bayesian dynamic latent state model for predicting infant sleep-wake patterns under daily massage intervention
##plugins.themes.bootstrap3.article.main##
Abstract
Sleep disturbances in infants present a persistent challenge for caregivers and healthcare providers. This study proposes a Bayesian Dynamic Latent State Model to predict infant sleep-wake patterns in response to daily massage, a non-pharmacological intervention. The model captures latent sleep propensity as a dynamic hidden process influenced by current and previous massages, individual random effects, and autoregressive components. Observed outcomes include nocturnal sleep duration and nighttime awakenings, modeled using Gaussian and Poisson distributions respectively. Through numerical simulations and a real-world case study, the model demonstrates clear benefits: average nocturnal sleep duration increased by approximately 1.2–1.5 hours, while nighttime awakenings decreased by about 35–40% on intervention days, with residual improvements on subsequent days. Compared to traditional static and time-series models, the proposed Bayesian approach provides greater flexibility in handling uncertainty, explicitly models carry-over effects, and integrates individual heterogeneity in sleep responses contributions that have not been fully addressed in prior infant sleep studies. This research thus advances the scientific understanding of dynamic, intervention-driven sleep processes, while also offering practical implications for evidence-based pediatric nursing and personalized infant care strategies. While promising, validation is currently limited to a small dataset and simplified assumptions. Future work will involve larger-scale testing, incorporation of additional external factors, and benchmarking against alternative machine learning models.
##plugins.themes.bootstrap3.article.details##
L. J. Meltzer, M. R. Plaufcan, J. H. Thomas, and J. A. Mindell, “Sleep problems and sleep disorders in pediatric primary care: treatment recommendations, persistence, and health care utilization,” J. Clin. Sleep Med., vol. 10, no. 4, pp. 421–426, 2014, doi: https://doi.org/10.5664/jcsm.3620.
D. Ophoff, M. A. Slaats, A. Boudewyns, I. Glazemakers, K. Van Hoorenbeeck, and S. L. Verhulst, “Sleep disorders during childhood: a practical review,” Eur. J. Pediatr., vol. 177, no. 5, pp. 641–648, 2018, doi: https://doi.org/10.1007/s00431-018-3116-z.
F. Jiang, “Sleep and early brain development,” Ann. Nutr. Metab., vol. 75, no. Suppl. 1, pp. 44–54, 2019, doi: https://doi.org/10.1159/000508055.
E. Bathory and S. Tomopoulos, “Sleep regulation, physiology and development, sleep duration and patterns, and sleep hygiene in infants, toddlers, and preschool-age children,” Curr. Probl. Pediatr. Adolesc. Health Care, vol. 47, no. 2, pp. 29–42, 2017, doi: https://doi.org/10.1016/j.cppeds.2016.12.001.
T. Field, “Infant sleep problems and interventions: a review,” Infant Behav. Dev., vol. 47, no. 2, pp. 40–53, 2017, doi: https://doi.org/10.1016/j.infbeh.2017.02.002.
W. Middlemiss, H. Stevens, L. Ridgway, S. McDonald, and M. Koussa, “Response-based sleep intervention: helping infants sleep without making them cry,” Early Hum. Dev., vol. 108, no. 5, pp. 49–57, 2017, doi: https://doi.org/10.1016/j.earlhumdev.2017.03.008.
S. Owais, C. H. T. Chow, M. Furtado, B. N. Frey, and R. J. Van Lieshout, “Non-pharmacological interventions for improving postpartum maternal sleep: A systematic review and meta-analysis,” Sleep Med. Rev., vol. 41, no. 10, pp. 87–100, 2018, doi: https://doi.org/10.1016/j.smrv.2018.01.005.
L. A. Shayani and V. R. F. da S. Maraes, “Manual and alternative therapies as non-pharmacological interventions for pain and stress control in newborns: a systematic review,” World J. Pediatr., vol. 19, no. 1, pp. 35–47, 2023, doi: https://doi.org/10.1007/s12519-022-00601-w.
R. Cassidy et al., “Mathematical modelling for health systems research: a systematic review of system dynamics and agent-based models,” BMC Health Serv. Res., vol. 19, no. 1, p. 845, 2019, doi: https://doi.org/10.1186/s12913-019-4627-7.
S. Scherer, M. Wimmer, U. Lotzmann, S. Moss, and D. Pinotti, “Evidence based and conceptual model driven approach for agent-based policy modelling,” J. Artif. Soc. Soc. Simul., vol. 18, no. 3, p. 14, 2015, doi: 10.18564/jasss.2834.
R. Rezaei, H. S. Nia, Z. Beheshti, and S. Saatsaz, “The efficacy of massage as a nightly bedtime routine on infant sleep condition and mother sleep quality: A randomized controlled trial,” J. Neonatal Nurs., vol. 29, no. 2, pp. 393–398, 2023, doi: https://doi.org/10.1016/j.jnn.2022.07.026.
A. F.-R. i Sabala and M. S. Y. Wang, “Enhancing Babies’ Sleep Schedule Prediction through Machine Learning,” 2024.
M. A. Rosswurm and J. H. Larrabee, “A model for change to evidence‐based practice,” Image J. Nurs. Scholarsh., vol. 31, no. 4, pp. 317–322, 1999, doi: https://doi.org/10.1111/j.1547-5069.1999.tb00510.x.
B. C. Galland, B. J. Taylor, D. E. Elder, and P. Herbison, “Normal sleep patterns in infants and children: a systematic review of observational studies,” Sleep Med. Rev., vol. 16, no. 3, pp. 213–222, 2012, doi: https://doi.org/10.1016/j.smrv.2011.06.001.
S. Janjarasjitt, M. S. Scher, and K. A. Loparo, “Nonlinear dynamical analysis of the neonatal EEG time series: the relationship between sleep state and complexity,” Clin. Neurophysiol., vol. 119, no. 8, pp. 1812–1823, 2008, doi: https://doi.org/10.1016/j.clinph.2008.03.024.
L. W. A. Hermans et al., “Representations of temporal sleep dynamics: Review and synthesis of the literature,” Sleep Med. Rev., vol. 63, no. 15, p. 101611, 2022, doi: https://doi.org/10.1016/j.smrv.2022.101611.
J. W. Forrester, “Industrial dynamics,” J. Oper. Res. Soc., vol. 48, no. 10, pp. 1037–1041, 1997, doi: https://doi.org/10.1057/palgrave.jors.2600946.
J. Swanson, “Business dynamics—systems thinking and modeling for a complex world,” J. Oper. Res. Soc., vol. 53, no. 4, pp. 472–473, 2002, doi: https://doi.org/10.1057/palgrave.jors.2601336.
A. H. Garde, K. Nabe-Nielsen, M. A. Jensen, J. Kristiansen, J. K. Sørensen, and Å. M. Hansen, “The effects of the number of consecutive night shifts on sleep duration and quality,” Scand. J. Work. Environ. Health, vol. 46, no. 4, p. 446, 2020, doi: https://doi.org/10.5271/sjweh.3885.
D. K. Das, “Exploring the symbiotic relationship between digital transformation, infrastructure, service delivery, and governance for smart sustainable cities,” Smart Cities, vol. 7, no. 2, pp. 806–835, 2024, doi: https://doi.org/10.3390/smartcities7020034.
R. Shi and J. F. MacGregor, “Modeling of dynamic systems using latent variable and subspace methods,” J. Chemom., vol. 14, no. 5‐6, pp. 423–439, 2000, doi: https://doi.org/10.1002/1099-128X(200009/12)14:5/6%3C423::AID-CEM615%3E3.0.CO;2-B.
. Bartolucci, A. Farcomeni, and F. Pennoni, “Latent Markov models: a review of a general framework for the analysis of longitudinal data with covariates,” Test, vol. 23, no. 3, pp. 433–465, 2014, doi: https://doi.org/10.1007/s11749-014-0381-7.
. Gunapati, A. Jain, P. K. Srijith, and S. Desai, “Variational inference as an alternative to MCMC for parameter estimation and model selection,” Publ. Astron. Soc. Aust., vol. 39, no. 2, p. e001, 2022, doi: https://doi.org/10.1017/pasa.2021.64.
P. Natesan, R. Nandakumar, T. Minka, and J. D. Rubright, “Bayesian prior choice in IRT estimation using MCMC and variational Bayes,” Front. Psychol., vol. 7, no. 3, p. 1422, 2016, doi: https://doi.org/10.3389/fpsyg.2016.01422.
J. Barido-Sottani, O. Schwery, R. C. M. Warnock, C. Zhang, and A. M. Wright, “Practical guidelines for Bayesian phylogenetic inference using Markov chain Monte Carlo (MCMC),” Open Res. Eur., vol. 3, no. 2, p. 204, 2024, doi: https://doi.org/10.12688/openreseurope.16679.3.

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.