Economic evaluation of strategies for managing crying and sleeping problems

Aims-To estimate the financial cost to the NHS of infant crying and sleepin g problems in the first 12 weeks of age and to assess the cost effectivenes s of behavioural and educational interventions aimed at reducing infant cry ing and sleeping problems relative to usual services. Methods-A cost burden analysis and cost effectiveness analysis were conduct ed using data from the Crying Or Sleeping Infants (COSI) Study, a three arm ed prospective randomised controlled trial that randomly allocated 610 moth ers to a behavioural intervention (n = 205), an educational intervention (n = 202), or existing services (control, n = 203). Main outcome measures wer e annual total cost to the NHS of infant crying and sleeping problems in th e first 12 weeks, and incremental cost per interruption free night gained f or behavioural and educational interventions relative to central. Results-The annual total cost to the NHS of infant crying and sleeping prob lems in the first 12 weeks was pound 65 million (US$104 million). Increment al costs per interruption free night gained for the behavioural interventio n relative to control were pound0.56 (US$0.92). For the educational interve ntion relative to control they were pound4.13 (US$6.80). Conclusions The annual total cost to the NHS of infant crying and sleeping problems is substantial. In the cost effectiveness analysis, the behavioura l intervention incurred a small additional cost and produced a small signif icant benefit at 11 and 12 weeks of age. The educational intervention incur red a small additional cost without producing a significant benefit.