Sleep problems in infancy and early school age in very preterm infants.


Journal

Early human development
ISSN: 1872-6232
Titre abrégé: Early Hum Dev
Pays: Ireland
ID NLM: 7708381

Informations de publication

Date de publication:
10 2022
Historique:
received: 19 06 2022
revised: 10 08 2022
accepted: 10 08 2022
pubmed: 21 8 2022
medline: 24 9 2022
entrez: 20 8 2022
Statut: ppublish

Résumé

Sleep plays an important role for psychological and physical health, especially in infants at high risk for long-term neurodevelopmental impairment such as preterm infants. Our study aimed at determining risk factors for long-term sleep impairment in very-preterm (VPT; <32 weeks of gestation) infants. Sleep problems were analyzed in an observational study in infants of the German Neonatal Network born between January 1st 2009 and December 31st 2014. Parental questionnaires of n = 2928 VPT children were evaluated regarding the child's sleep behavior at five years of age. Univariate and logistic regression analyses were used to identify risk factors for delayed sleep onset and hyperactivity/inattention (Strength and Difficulties Questionnaire). In a second cohort of n = 342 VPT infants, sleep habits were evaluated at toddlers age via the Infant Sleep Questionnaire. In our cohorts, 424/2928 (14.5 %) preterm children were diagnosed with delayed sleep onset at early school age while 57/342 (16.7 %) had sleep impairment in early infancy. Gestational age was not independently associated with sleep problems (i.e., early school age: OR 0.97, 95 % CI 0.9-1.1, p = 0.15). Notably, in both our cohorts, neonatal exposure to analgesics and sedatives was associated with a higher risk for sleep problems, i.e., early school age: exposure to sedatives: OR 1.31, 95%CI 1.02-1.7, p = 0.03. Sleep problems and drug exposure were both associated with hyperactivity/inattention. Sleep problems of VPT children are unrelated to gestational age which suggests rather individual risk factors. The significant neonatal exposure to analgesics and sedatives may contribute to long-term sleep impairment.

Sections du résumé

BACKGROUND
Sleep plays an important role for psychological and physical health, especially in infants at high risk for long-term neurodevelopmental impairment such as preterm infants.
OBJECTIVE
Our study aimed at determining risk factors for long-term sleep impairment in very-preterm (VPT; <32 weeks of gestation) infants.
METHODS
Sleep problems were analyzed in an observational study in infants of the German Neonatal Network born between January 1st 2009 and December 31st 2014. Parental questionnaires of n = 2928 VPT children were evaluated regarding the child's sleep behavior at five years of age. Univariate and logistic regression analyses were used to identify risk factors for delayed sleep onset and hyperactivity/inattention (Strength and Difficulties Questionnaire). In a second cohort of n = 342 VPT infants, sleep habits were evaluated at toddlers age via the Infant Sleep Questionnaire.
RESULTS
In our cohorts, 424/2928 (14.5 %) preterm children were diagnosed with delayed sleep onset at early school age while 57/342 (16.7 %) had sleep impairment in early infancy. Gestational age was not independently associated with sleep problems (i.e., early school age: OR 0.97, 95 % CI 0.9-1.1, p = 0.15). Notably, in both our cohorts, neonatal exposure to analgesics and sedatives was associated with a higher risk for sleep problems, i.e., early school age: exposure to sedatives: OR 1.31, 95%CI 1.02-1.7, p = 0.03. Sleep problems and drug exposure were both associated with hyperactivity/inattention.
CONCLUSION
Sleep problems of VPT children are unrelated to gestational age which suggests rather individual risk factors. The significant neonatal exposure to analgesics and sedatives may contribute to long-term sleep impairment.

Identifiants

pubmed: 35987047
pii: S0378-3782(22)00119-0
doi: 10.1016/j.earlhumdev.2022.105656
pii:
doi:

Substances chimiques

Hypnotics and Sedatives 0

Types de publication

Journal Article Observational Study Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

105656

Informations de copyright

Copyright © 2022. Published by Elsevier B.V.

Déclaration de conflit d'intérêts

Declaration of competing interest The authors declare no conflict of interests.

Auteurs

Johanna Neitmann (J)

Department of Pediatrics, University of Luebeck, Luebeck, Germany.

Kathrin Hanke (K)

Department of Pediatrics, University of Luebeck, Luebeck, Germany. Electronic address: kathrin.hanke@uksh.de.

Alexander Humberg (A)

Department of Pediatrics, University of Luebeck, Luebeck, Germany. Electronic address: alexander.humberg@uksh.de.

Bastian Siller (B)

Department of Pediatrics, University of Luebeck, Luebeck, Germany. Electronic address: bastian.siller@uksh.de.

Juliane Spiegler (J)

Department of Pediatrics, University Hospital of Wuerzburg, Wuerzburg, Germany. Electronic address: spiegler_j@ukw.de.

Karla Juhnke (K)

Department of Pediatrics, University of Luebeck, Luebeck, Germany.

Jessica Gilmore (J)

Department of Pediatrics, University of Luebeck, Luebeck, Germany. Electronic address: jessica.gilmore@student.uni-luebeck.de.

Rainer Odendahl (R)

Department of Pediatrics, University of Luebeck, Luebeck, Germany. Electronic address: info@kjm-klingenberg.de.

Egbert Herting (E)

Department of Pediatrics, University of Luebeck, Luebeck, Germany. Electronic address: Egbert.herting@uksh.de.

Wolfgang Göpel (W)

Department of Pediatrics, University of Luebeck, Luebeck, Germany. Electronic address: Wolfgang.goepel@uksh.de.

Christoph Härtel (C)

Department of Pediatrics, University Hospital of Wuerzburg, Wuerzburg, Germany. Electronic address: Haertel_C1@ukw.de.

Ingmar Fortmann (I)

Department of Pediatrics, University of Luebeck, Luebeck, Germany. Electronic address: matsingmar.fortmann@uksh.de.

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