Being Born Too Small and Too Early May Alter Sleep in Childhood

Stephanie R Yiallourou; Bianca C Arena; Euan M Wallace; Alexsandria Odoi; Samantha Hollis; Aidan Weichard; Rosemary S C Horne

doi:10.1093/sleep/zsx193

Being Born Too Small and Too Early May Alter Sleep in Childhood

Sleep. 2018 Feb 1;41(2):zsx193. doi: 10.1093/sleep/zsx193.

Authors

Stephanie R Yiallourou^{1

2}, Bianca C Arena¹, Euan M Wallace³, Alexsandria Odoi¹, Samantha Hollis¹, Aidan Weichard¹, Rosemary S C Horne¹

Affiliations

¹ Department of Paediatrics, The Ritchie Centre, Hudson Institute of Medical Research, Monash University, Melbourne, Victoria, Australia.
² Pre-Clinical Disease and Prevention Unit, Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia.
³ Department of Obstetrics and Gynaecology, The Ritchie Centre, Hudson Institute of Medical Research, Monash University, Melbourne, Victoria, Australia.

PMID: 29165677
DOI: 10.1093/sleep/zsx193

Abstract

Study objectives: Fetal growth restriction (FGR) occurs in up to 10% of pregnancies and is associated with increased risk of prematurity and neurodevelopmental impairment. FGR also alters sleep-state distribution in utero and maturation in infancy. Currently, limited data on the long-term associations of FGR and childhood sleep exist. Accordingly, we assessed the associations between preterm birth and FGR and sleep in children aged 5-12 years.

Methods: Seventeen children born preterm and FGR, 15 children born preterm but appropriately grown (appropriate birth weight for gestational age [AGA]), and 20 term AGA children (controls) were studied using overnight polysomnography. Sleep macroarchitecture was assessed using standard criteria, and sleep microarchitecture was assessed using spectral analysis of the electroencephalogram (C4-M1) with total, δ (0.5-3.9 Hz), θ (4.0-7.9Hz), α (8.0-11.9 Hz), σ (12.0-13.9 Hz), and β power (14.0-30 Hz) calculated.

Results: For sleep macroarchitecture, preterm FGR children had higher N2% compared with term AGA children (p < .05). Preterm AGA children had reduced total sleep time, NREM%, and sleep efficiency compared with term AGA children (p < .05 for all). For sleep microarchitecture, preterm FGR children had a higher amount of total, δ and α power compared with both groups (p < .05). Sigma and β power was lowest in the preterm AGA group compared with both groups (p < .05 for both).

Conclusions: Prematurity and FGR were associated with altered sleep macro- and microarchitecture measures indicative of reduced sleep quantity and quality in childhood. As sleep disturbance can affect both behavior and neurodevelopment in children, sleep in FGR and preterm children warrants further investigation.

Keywords: EEG spectral analysis; fetal growth restriction; pediatric; preterm birth; sleep.