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Propranolol's effects on the sleep of infants with hemangiomas: A prospective pilot study
Stephanie Frost1, Vishal Saddi2,3, Arthur Teng3
1UNSW Medicine, University of New South Wales, Sydney, NSW, Australia.
Insights
Propranolol treatment for infantile hemangioma in infants and toddlers did not significantly disrupt sleep patterns. Most parents reported only minor sleep issues, with objective measures showing no significant changes.
Area of Science:
- Pediatric Dermatology
- Sleep Medicine
- Pharmacology
Background:
- Infantile hemangioma is a common vascular tumor in infants.
- Propranolol is a first-line treatment for problematic infantile hemangiomas.
- The impact of propranolol on infant sleep requires further investigation.
Purpose of the Study:
- To evaluate the effect of propranolol on sleep in infants and toddlers with infantile hemangioma.
- To compare sleep patterns before and after initiating propranolol treatment.
Main Methods:
- A cohort of 55 infants and toddlers with infantile hemangioma requiring propranolol treatment were enrolled.
- Sleep was assessed using the Brief Infant Sleep Questionnaire (BISQ) and actigraphy before and 5 weeks after propranolol initiation.
- Parental reports and objective actigraphy data were analyzed.
Main Results:
- Most parents reported only minor sleep problems after 5 weeks of propranolol (P = .049).
- While subjective reports showed increased nighttime sleep and decreased daytime naps (P < .05), objective actigraphy in a subset of 10 infants revealed no significant changes in sleep quality.
- Subgroup analysis of infants under 6 months showed no significant sleep differences.
Conclusions:
- Propranolol treatment for infantile hemangioma does not appear to significantly impair sleep quality or patterns in infants and toddlers.
- Observed sleep changes were generally minor and not consistently supported by objective measures.
Objective:
To assess propranolol's impact on sleep when used in infants and toddlers with infantile hemangioma (80% under 6 months old).
Methods:
Parents and caregivers of infants and toddlers with infantile hemangioma presenting to a tertiary pediatric hospital's dermatology clinic and assessed by their dermatologist as requiring propranolol treatment were invited to participate. All participants completed an extended version of the Brief Infant Sleep Questionnaire (BISQ) prior to propranolol treatment initiation, which acted as the control, and 5 weeks after treatment commencement. Objective data were gathered through actigraphy, which utilizes a small wristwatch-like device that measures sleep-wake patterns, for 1 week prior to initiation and again 5 weeks after commencement. BISQ responses and actigraphy values from the two time points were compared.
Results:
55 infants and toddlers (aged 0-2.8 years, 80% under 6 months) were included. Sleep was reported as only a minor problem by most parents 5 weeks after starting propranolol (P = .049). Subgroup analysis of 45 infants <6 months old showed no significant difference in sleep while taking propranolol. Whole cohort BISQ data analysis showed a statistically significant increase in night-time sleep (P = .024), and a decrease in the number (P = .003) and duration of daytime naps (P = .025) following commencement of propranolol. Actigraphy data completed in 10 infants showed no significant difference in sleep quality before and 5 weeks after commencing propranolol.
Conclusion:
Propranolol did not significantly impair sleep quality and pattern in our cohort of infants and toddlers with infantile hemangioma. Most parents considered the impact on sleep to be only a minor problem.
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