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Disturbed sleep in children born extremely preterm is associated with behavioural and emotional symptoms

Jayne Trickett1, Marialivia Bernardi2, Amanda Fahy2

  • 1Department of Health Sciences, University of Leicester, Leicester, United Kingdom; Centre for Mathematical Cognition, School of Science, Loughborough University, Loughborough, United Kingdom.

Sleep Medicine
|August 1, 2021
PubMed

Insights

Children born extremely preterm experience more sleep disturbances, including snoring and night wakings. Addressing these sleep issues may help reduce attention and emotional problems in these children.

Area of Science:

  • Pediatric Sleep Medicine
  • Developmental Pediatrics
  • Neurodevelopmental Disorders

Background:

  • Extremely preterm birth is associated with various neurodevelopmental challenges.
  • Sleep disturbances are common in childhood but may be more prevalent in preterm populations.
  • The relationship between extremely preterm birth, sleep, and behavioral outcomes requires further investigation.

Purpose of the Study:

  • To assess the risk of sleep disturbances in children born extremely preterm compared to term-born children.
  • To explore the links between extremely preterm birth, sleep patterns, and symptoms of attention-deficit/hyperactivity disorder (ADHD) and emotional problems.
  • To investigate potential mediating roles of sleep disturbances in the association between preterm birth and behavioral symptoms.

Main Methods:

  • Utilized the EPICure2 cohort study data.
  • Parents of 165 extremely preterm children (born ≤26 weeks' gestation) and 121 term-born children completed validated sleep, ADHD, and emotional problems questionnaires at age 11.
  • Statistical analyses included adjusted odds ratios and Cohen's d to compare groups and mediation analyses to explore relationships.

Main Results:

  • Children born extremely preterm exhibited significantly higher rates of habitual snoring, difficulty falling asleep, increased night wakings, and daytime sleepiness compared to term-born controls.
  • Among children without severe disabilities, night wakings partially mediated the association between preterm birth and inattention, hyperactivity/impulsivity, and emotional problems.
  • Snoring also partially mediated the relationship between preterm birth and hyperactivity/impulsivity and inattention.

Conclusions:

  • Children born extremely preterm are at a heightened risk for significant sleep disturbances.
  • Interventions targeting sleep disturbances, such as reducing night wakings, may be beneficial in mitigating attention and emotional problems in extremely preterm-born children.
  • Sleep quality is a critical factor influencing neurobehavioral outcomes in this vulnerable population.
Abstract

Keywords:
ADHDChildhoodEmotional problemsPreterm birthSleep

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