Prevalence and Determinants of Bed-Sharing Among Infants and Toddlers in Jeddah, Saudi Arabia: A Cross-Sectional Study.

BACKGROUND: Bed-sharing is a prevalent but contested sleep practice with important child safety implications. Population-specific data from Saudi Arabia remain limited among children aged up to four years. OBJECTIVE: To determine the prevalence of bed-sharing among infants and toddlers in Jeddah, identify associated factors, and examine its relationship with sleep outcome. METHODS: This cross-sectional study used consecutive sampling to enrol 437 children aged one month to four years at primary healthcare centres and paediatric clinics affiliated with King Abdulaziz University Hospital, Jeddah, between September 2025 and January 2026. Sleep data, collected using the Brief Infant Sleep Questionnaire-Revised Short Form (BISQ-R-SF), were analysed using the Mann-Whitney U-test, chi-square test, and logistic regression. RESULTS: Bed-sharing prevalence was 87.2%. Exclusive breastfeeding was independently associated with lower bed-sharing odds ratios (multivariate OR: 0.44; 95% CI: 0.25-0.80; p = 0.007). The receipt of safe sleep counselling was paradoxically associated with higher odds of bed-sharing (OR: 1.89; 95% CI: 1.03-3.47; p = 0.042). Most sleep parameters were similar between groups; however, the sleep problem score was higher among non-bed-sharing children [median 3 (IQR 2) vs 2 (IQR 2); p = 0.039]. Sleep consolidation improved progressively with age. CONCLUSION: Bed-sharing was highly prevalent among young Saudi children but was not associated with worse sleep outcomes in this cohort; sleep consolidation instead improved with age in both bed-sharing and non-bed-sharing children. Because the cross-sectional design precludes causal inference, counselling should be culturally sensitive, behaviorally grounded, and focused on modifiable risk practices rather than bed-sharing status alone.