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Sleep disturbance in children with prenatal alcohol exposure: a systematic review and meta-analysis

Emma Louise Gale1, Chloe Anna Hunt2

  • 1Population and Behavioural Science, School of Medicine, University of St Andrews, Scotland, UK.

Sleep Medicine Reviews
|November 2, 2025
PubMed

Insights

Children with prenatal alcohol exposure (PAE) experience significant sleep disturbances, including difficulty falling asleep and frequent awakenings. These issues worsen with increased exposure, emphasizing the need for early intervention.

Area of Science:

  • Neuroscience
  • Developmental Psychology
  • Pediatrics

Background:

  • Sleep disturbances are common in children with prenatal alcohol exposure (PAE), potentially worsening behavioral and cognitive issues.
  • Existing research lacks a systematic review on the timing and severity of these sleep problems.
  • Prenatal Alcohol Spectrum Disorders (FASD) are associated with sleep disturbances.

Purpose of the Study:

  • To systematically identify and characterize sleep disturbances in children with PAE.
  • To assess the relationship between PAE severity and sleep problems.
  • To review the timing and persistence of sleep disturbances in children with PAE.

Main Methods:

  • Systematic literature search across seven databases adhering to PRISMA guidelines.
  • Inclusion of studies with children aged 3-10 years with PAE and quantitative sleep data.
  • Independent screening by two reviewers and meta-analysis of subjective sleep outcomes using a random-effects model.

Main Results:

  • Fourteen studies confirmed worse sleep in children with PAE compared to controls.
  • Children with PAE exhibited longer sleep onset, shorter duration, more awakenings, and lower sleep efficiency.
  • Higher PAE levels correlated with earlier onset and persistent sleep disturbances, particularly with early pregnancy exposure.

Conclusions:

  • Children with PAE experience persistent sleep disturbances that are exacerbated by earlier and heavier exposure.
  • Early screening for sleep disturbances in children with PAE is crucial.
  • Interventions targeting sleep problems in children with PAE are necessary.
Abstract

Keywords:
ChildhoodDevelopmental disordersFetal alcohol syndrome disordersPregnancyPrenatal substance disordersSubstance use during pregnancy

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