Caffeine in Preterm Infants and its Effect on Neonatal Sleep: A Systematic Review

Area of Science:

• Neonatal Medicine
• Developmental Pediatrics
• Pharmacology

Background:

• Preterm infants in neonatal intensive care units (NICUs) often experience poor sleep quality, impacting development.
• Caffeine is commonly administered to preterm infants as a stimulant, but its effects on sleep are not fully understood.

Purpose of the Study:

• To systematically review existing evidence on the sleep-disruptive effects of caffeine in preterm infants within the first month of life.
• To assess caffeine's impact on sleep-wake states and sensorimotor functioning in this vulnerable population.

Main Methods:

• A comprehensive literature search was conducted across major databases (PubMed, Embase, Scopus, PsycInfo, CENTRAL) following PRISMA guidelines.
• Included studies focused on preterm infants (<37 weeks gestational age) receiving caffeine in the NICU, with sleep measures recorded within the first month.
• Eight studies met the eligibility criteria, with results analyzed using albatross plots.

Main Results:

• 83.33% of studies reported significant caffeine-induced disruptions in wakefulness among preterm infants.
• 100% of studies indicated significant reductions in sensorimotor functioning.
• Significant reductions in sleep states were also observed, suggesting potential alterations in sleep architecture.

Conclusions:

• Available evidence suggests caffeine exposure may alter sleep-wake and sensorimotor functioning in preterm infants during the first month.
• The overall evidence is mixed, with some studies showing no effect, highlighting the need for further investigation.
• Understanding caffeine's precise impact on neonatal sleep quality is crucial for optimizing care in the NICU.