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The sleep patterns of infants and young children with gastro-oesophageal reflux
M Ghaem1, K L Armstrong, O Trocki
1Department of Gastroenterology, Royal Children's Hospital and District Health Service, Herston, Queensland, Australia.
Insights
Infants and children with gastro-oesophageal reflux disease (GORD) experience more frequent sleep disturbances, including night waking and difficulty settling. Early evaluation of sleep issues in infants over 3 months can aid in accurate GORD diagnosis.
Area of Science:
- Pediatric Gastroenterology
- Sleep Medicine
- Infant Health
Background:
- Sleep disturbance is a common concern in infants and young children.
- Gastro-oesophageal reflux disease (GORD) is a prevalent condition in this age group.
- The relationship between GORD and sleep patterns in young children has not been systematically studied.
Purpose of the Study:
- To systematically study sleep disturbance in infants and young children with GORD.
- To compare the sleep patterns of children with GORD to population norms.
- To investigate the impact of GORD on infant sleep behavior.
Main Methods:
- A cohort of 102 infants and children (1-36 months) with and without GORD (diagnosed via pH monitoring) were analyzed.
- Sleep patterns were assessed using a standardized questionnaire, comparing outcomes to population data.
- Key measures included time to settle, night wakings, daytime sleep, and parental sleep problems.
Main Results:
- Infants and children with GORD showed significantly higher rates of night waking (>3/night) and need for parental intervention compared to population norms.
- Delayed onset of sleeping through the night and increased daytime sleep beyond 24 months were observed in the GORD group.
- Comparisons between children with and without GORD also revealed significant differences in sleep patterns, though less pronounced.
Conclusions:
- Sleep interruption is more prevalent in infants and children diagnosed with GORD.
- Objective evaluation of sleep disturbance in infants over 3 months may prevent misdiagnosis of GORD.
- Further systematic research is needed to understand GORD's contribution to sleep problems in young children.
Objective:
Sleep disturbance in gastro-oesophageal reflux disease (GORD) in infants and young children has not been systematically studied nor has this manifestation been compared with population norms.
Methods:
Sleep patterns of 102 infants and children aged 1 to 36 months with and without GORD, defined by pH monitoring, were analysed using the same questionnaire as in recent studies of normal sleep behaviour in this age range. Main outcome measures included time taken to settle at night, the number of night time wakenings requiring parental intervention, day time sleep patterns and parents problems with their childs' sleep behaviour.
Results:
Compared with the population norms (n=3102), those with GORD (n=76) had greater prevalence of night time waking >3/night (50% vs 13% aged 3-12 months; 60% vs 10% aged 12-24 months, P<0.001), requirement of parental intervention (82% vs 55% aged 3-12 months, P<0.05; 92% vs 55% aged 12-24 months, P<0.001), significantly delayed onset of sleeping through the night, and greater prevalence of daytime sleep beyond 24 months. Similar but less striking differences were seen comparing those with (n=76) and without GORD (n=26).
Conclusions:
Sleep interruption occurs more frequently in infants and children with GORD than population norms. Objective evaluation of infants and children with sleep disturbance after the age of 3 months may avoid unnecessary over or under diagnosis of GORD. Systematic investigation of the contribution of GORD to sleep disturbance in infants and young children is warranted.