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Association between neonatal phototherapy and sleep: The Japan Environment and Children's Study
Masashi Hotta1, Kimiko Ueda2, Satoyo Ikehara3,4
1Department of Neonatal Medicine, Osaka Women's and Children's Hospital, Izumi, Japan.
Insights
Longer neonatal phototherapy duration was linked to shorter infant sleep at one month. Shorter phototherapy duration was associated with later sleep onset and offset at 1.5 years, suggesting transient effects on infant sleep patterns.
Area of Science:
- Neonatal care
- Developmental pediatrics
- Sleep medicine
Background:
- Neonatal jaundice is common and often treated with phototherapy.
- The long-term effects of phototherapy on infant development, particularly sleep, require further investigation.
Purpose of the Study:
- To examine the association between the duration of neonatal phototherapy and infant sleep-wake states.
- To assess these associations at one month, 1.5 years, and 3 years of age.
Main Methods:
- Analysis of data from 77,876 infants in the Japan Environment and Children's Study.
- Categorization into no phototherapy, short phototherapy (1-24 hours), and long phototherapy (>24 hours) groups.
- Multiple regression analysis adjusted for potential risk factors.
Main Results:
- Longer phototherapy duration correlated with reduced total sleep time per 24 hours at one month (β = -0.62).
- Short phototherapy duration was linked to later sleep onset (β = 0.04) and offset (β = 0.05) at 1.5 years compared to no phototherapy.
- No significant associations were found at 3 years of age.
Conclusions:
- The duration of neonatal phototherapy may have transient effects on infant sleep duration at one month.
- Later sleep onset and offset observed at 1.5 years suggest potential longer-term, though mild, sleep pattern alterations.
Abstract:
This observational cohort study aimed to evaluate the association between the duration of neonatal phototherapy and sleep-and-wakefulness states at 1 month, 1.5 years, and 3 years of age. We analysed data from 77,876 infants using the Japan Environment and Children's Study, a nationwide birth cohort study. The participants were divided into three groups: no phototherapy, short phototherapy (1-24 h), and long phototherapy (>24 h). Multiple regression analysis was performed to assess the effect of phototherapy duration on infant sleep at each age after adjusting for potential risk factors. A longer duration of phototherapy was associated with a shorter sleep time over 24 h at 1 month of age (β, -0.62; SE, -0.77 to -0.47) when compared with a shorter duration of, or no, phototherapy, following the adjustment of confounding factors. Contrastingly, the short duration group, when compared with the no phototherapy group, was associated with later sleep onset (β, 0.04; SE, 0.00-0.08) and later sleep offset (β, 0.05; SE, 0.01-0.09) at 1.5 years of age. We concluded that the duration of phototherapy may be transiently associated with sleep duration in infants, as emphasised by the shortening of the total sleep time per 24 h at 1 month of age.
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