Background Managing sleep is a challenging experience in early parenthood, and infant sleep problems are associated with negative outcomes within the family. A large market of devices to monitor infants’ real-time health information during sleep has emerged, including smart cameras, under-mattress sensors, and wearable devices. The impacts of these products on maternal and parental mental health and medical decision-making are poorly understood.

Methods We performed a systematic search for products detecting health data from sleeping children on the global retail platform Amazon in March 2023. A total of 11,262 unique reviews from 48 eligible products were retrieved from the US, Canada, UK, and Australia sites and subjected to sentiment and thematic analyses to capture the characteristics of user families, contexts of device use, and impacts on maternal and child health.

Results Parental anxiety and infants’ high-risk medical status were cited as main reasons to purchase products. When devices worked well, their use was associated with improved parental sleep quality and decreased anxiety. However, poor device performance was commonly reported and was linked to increased parental stress and anxiety and disrupted child sleep. Users reported making medical decisions based on device output. Price, privacy, and unsafe use of devices emerged as ethical issues.

Conclusions Use of a smart sleep device in the home is common and has implications for the health of both children and adults. Benefits and harms must be understood by parents and healthcare providers in order to support evidence-based decision-making around their use.

What is already known

Many households monitor sleeping children’s health using emerging “smart” commercial products such as cameras, sensors, and wearables.

The medical community is not yet prepared to offer evidence-based recommendations about these practices, despite their widespread adoption and potential intersection with the healthcare system.

What this study adds

By conducting a content analysis of a large corpus of consumer reviews, we find evidence that these devices impact maternal and parental mental health, children’s sleep quality and safety, and family usage of healthcare services.

How this study might affect research, practice or policy

These results will inform future development of recommendations for sleep device use.

With a better understanding of how these devices affect user families, parents can be more equipped to make evidence-informed decisions for their family’s health.

The authors have declared no competing interest.

This work was supported by a Michael Smith Health Research BC Fellowship to JAD, a Natural Sciences and Engineering Research Council (NSERC) Fellowship to JAD, funding from BC Children's Hospital Research Institute to JMR and from the BC Children's Hospital Foundation to JMR.

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