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Sleep-disordered breathing symptoms and their association with structural and functional pulmonary changes in

Victoria Griffiths1, Henrietta Blinder2, Lamia Hayawi2

  • 1Department of Pediatrics, Children's Hospital of Eastern Ontario, University of Ottawa, Ottawa, ON, Canada.

European Journal of Pediatrics
|October 18, 2022
PubMed

Insights

Children born extremely preterm without bronchopulmonary dysplasia (BPD) showed no significant differences in sleep symptoms compared to those with BPD. Daytime sleepiness was linked to airflow limitation, not BPD itself.

Area of Science:

  • Pediatric Pulmonology
  • Sleep Medicine
  • Neonatology

Background:

  • Children born extremely preterm face increased risks for lung structural and functional differences, including sleep-disordered breathing (SDB).
  • Bronchopulmonary dysplasia (BPD), a chronic lung disease in premature infants, may exacerbate SDB, but its specific impact requires further study.

Purpose of the Study:

  • To evaluate sleep-disordered breathing (SDB) symptoms in children aged 7-9 years born extremely preterm, comparing those with and without a history of bronchopulmonary dysplasia (BPD).
  • To investigate associations between sleep symptoms, respiratory symptoms, physical activity, pulmonary function, and pulmonary MRI findings in this cohort.

Main Methods:

  • A multi-center, cross-sectional study involving 45 children born extremely preterm (7-9 years old) with and without moderate-to-severe BPD.
  • Data collection included the Pediatric Sleep Questionnaire (PSQ), modified Epworth sleepiness scale, respiratory questionnaires, pedometry, pulmonary function tests, and pulmonary MRI.
  • Statistical analyses involved Spearman correlations and univariate/multivariable linear regression models.

Main Results:

  • The prevalence of most sleep-related symptoms was low, except for hyperactivity and inattention.
  • No statistically significant differences in sleep questionnaire scores were found between children with and without BPD, even after adjusting for gestational age and intraventricular hemorrhage.
  • Greater daytime sleepiness showed a moderate negative correlation with FEV1%-predicted (r=-0.52), indicating an association with airflow limitation.

Conclusions:

  • Clinically significant differences in sleep symptoms were not observed between extremely preterm children with and without BPD.
  • Sleep symptoms in this population appear more related to prematurity-related factors, such as airflow limitation, rather than a BPD diagnosis alone.
  • Further research is warranted to elucidate the complex interplay between sleep symptoms, airway obstruction, and neurobehavioral outcomes in premature infants.

Keywords:
Bronchopulmonary dysplasiaDaytime sleepinessPhysical activitySleep-disordered breathing

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