Children born extremely preterm had different sleeping habits at 11 years of age and more childhood sleep problems than term‐born children

Stangenes, Kristine Marie; Fevang, Silje Kathrine; Grundt, Jacob Holter; Donkor, Hilde Mjell; Markestad, Trond; Hysing, Mari; Elgen, Irene Bircow; Bjorvatn, Bjørn

doi:10.1111/apa.13991

Cited by 39 publications

(35 citation statements)

References 28 publications

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“…In 11‐year‐old children born very preterm (<28 weeks completed GA, or weighing <1000 g), who had neurodevelopmental disabilities (assessed at 5 years of age), there was a higher percentage of sleep problems compared to term‐matched control counterparts (Stangenes et al . ). The preterm‐born infants went to bed earlier, had longer sleep‐onset latency, increased night waking, and they slept longer.…”

Section: Introductionmentioning

confidence: 97%

“…Notably, however, preterm infants with no reported neurodevelopmental disabilities also had sleep difficulties, which were similar to those reported for their preterm counterparts with neurodevelopmental disabilities (Stangenes et al . ). Longer nocturnal sleep duration, more night awakenings, and longer daytime sleep duration was also observed in 6‐month‐old infants born at an older age (31.5 ± 3.2 weeks GA, 1467 ± 588.6 g, mean±SD) compared to term control infants (Huang et al .…”

Section: Introductionmentioning

confidence: 97%

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Waking up too early – the consequences of preterm birth on sleep development

Bennet

Walker

Horne

2018

The Journal of Physiology

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Good quality sleep of sufficient duration is vital for optimal physiological function and our health. Sleep deprivation is associated with impaired neurocognitive function and emotional control, and increases the risk for cardiometabolic diseases, obesity and cancer. Sleep develops during fetal life with the emergence of a recognisable pattern of sleep states in the preterm fetus associated with the development, maturation and connectivity within neural networks in the brain. Despite the physiological importance of sleep, surprisingly little is known about how sleep develops in individuals born preterm. Globally, an estimated 15 million babies are born preterm (<37 weeks gestation) each year, and these babies are at significant risk of neural injury and impaired brain development. This review discusses how sleep develops during fetal and neonatal life, how preterm birth impacts on sleep development to adulthood, and the factors which may contribute to impaired brain and sleep development, leading to altered neurocognitive, behavioural and motor capabilities in the infant and child. Going forward, the challenge is to identify specific risk factors for impaired sleep development in preterm babies to allow for the design of interventions that will improve the quality and quantity of sleep throughout life.

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Section: Introductionmentioning

confidence: 97%

Section: Introductionmentioning

confidence: 97%

Waking up too early – the consequences of preterm birth on sleep development

Bennet

Walker

Horne

2018

The Journal of Physiology

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“…Furthermore, for an α = 0.05 and 1-β = 0.8, even our weakest main comparison between the early preterm group (n = 83) and controls (n = 341) in the actigraphy analysis would be able to detect or exclude a mean difference of 0.34 SD. This is charitable considering that the mean effect size in studies that investigate preterm circadian preference (Asaka & Takada 2010;Björkqvist et al 2014;Hibbs et al 2014;Maurer et al 2016;Natale et al 2005;Stangenes et al 2017;Strang-Karlsson et al 2008;Strang-Karlsson et al 2010), and in adult VLBW studies in general, tend to be around the order of magnitude of~0.5 (Hovi et al 2007;Pyhälä et al 2011). The few formally statistically significant differences showed no consistent pattern and are likely to have arisen by chance, or are possibly related to issues not studied here.…”

Section: Discussionmentioning

confidence: 99%

“…Also, among 13-year-old preterms (<37 weeks), a larger proportion were "morning types" compared to controls when assessed with the Junior MEQ and Junior Composite Scale (Natale et al 2005). A Norwegian questionnaire study (Stangenes et al 2017) of extremely preterm (<28 weeks or ELBW) 11-year-olds displayed 0.4h earlier bedtime, but correspondingly longer time in bed. Most participants of the aforementioned studies are characterized by a very low birth weight and/or very short gestational age.…”

Section: Introductionmentioning

confidence: 92%

Premature birth and circadian preference in young adulthood: evidence from two birth cohorts

Björkqvist

Pesonen

Kuula

et al. 2018

Chronobiology International

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A preference for eveningness (being a "night owl") and preterm birth (<37 weeks of gestation) are associated with similar adversities, such as elevated blood pressure, impaired glucose regulation, poorer physical fitness, and lower mood. Yet, it remains unclear if and how preterm birth is associated with circadian preference. The aim of this study was to assess this association across the whole gestation range, using both objective and subjective measurements of circadian preference. Circadian preference was measured among 594 young adults (mean age 24.3 years, SD 1.3) from two cohorts: the ESTER study and the Arvo Ylppö Longitudinal Study. We compared 83 participants born early preterm (<34 weeks) and 165 late preterm (34 to <37 weeks) with those born at term (≥37 weeks, n = 346). We also compared very low birth weight (VLBW, <1500 g) participants with term-born controls. We obtained objective sleep data with actigraphs that were worn for a mean period of 6.8 (SD 1.4) nights. Our primary outcome was sleep midpoint during weekdays and weekend. The sleep midpoint is the half-way time between falling asleep and waking up, and it represents sleep timing. We also investigated subjective chronotype with the Morningness-Eveningness Questionnaire (MEQ) in 688 (n = 138/221/329) ESTER participants. The MEQ consists of 19 questions, which estimates the respondent to be of a "morning", "evening," or "intermediate" chronotype, based on the Morningness-Eveningness Score (MES). We analyzed the data from the actigraphs and the MES with three linear regression models, and analyzed distribution of the chronotype class with Pearson χ2. There were no consistent differences across the study groups in sleep midpoint. As compared with those born at term, the mean differences in minutes:seconds and 95% confidence intervals for the sleep midpoint were: early preterm weekdays 11:47 (-8:34 to 32:08), early preterm weekend 4:14 (-19:45 to 28:13), late preterm weekdays -10:28 (-26:16 to 5:21), and late preterm weekend -1:29 (-20:36 to 17:37). There was no difference in sleep timing between VLBW-participants and controls either. The distribution of chronotype in the MEQ among all participants was 12.4% morningness, 65.4% intermediate, and 22.2% eveningness. The distribution of the subjective chronotype class did not differ between the three gestational age groups (p = 0.98). The linear regression models did not show any influence of gestational age group or VLBW status on the MES (all p > 0.5). We found no consistent differences between adults born early or late preterm and those born at term in circadian preference. The earlier circadian preference previously observed in those born smallest is unlikely to extend across the whole range of preterm birth.

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“…We have previously shown that children born extremely preterm (EPT) have more sleep problems throughout childhood than children born at term, and that the prevalence increases with the degree of neurodevelopmental disability 10. Children born EPT are also at increased risk of behavioural problems and respiratory morbidities,11 12 but we do not know how such difficulties affect their sleep.…”

Section: Introductionmentioning

confidence: 99%

Sleep problems, behavioural problems and respiratory health in children born extremely preterm: a parental questionnaire study

Stangenes

Hysing

Elgen

et al. 2019

bmjpo

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ObjectiveTo explore whether children born extremely preterm (EPT) with different types of sleep problems had more behavioural and respiratory health problems than EPT children without sleep problems.DesignProspective, nationwide, questionnaire-based study. At 11 years of age, parents reported on four current sleep problems: difficulty falling asleep or frequent awakenings, snoring, daytime sleepiness and not recommended sleep duration (<9 hours). Behavioural problems were assessed by parents and teachers with the Strengths and Difficulties Questionnaire (SDQ). Parents assessed respiratory symptoms with the International Study of Asthma and Allergies in Childhood questionnaire and described use of asthma medication.SettingNorway.PatientsEPT children.Main outcome measuresSpecified sleep problems, behavioural problems and respiratory health.ResultsData were obtained from 216 of 372 (58 %) of eligible children. All four specified sleep problems were associated with significantly higher parent-reported SDQ total-score (OR 1.1 for all), and except for not recommended sleep duration, also with higher teacher-reported SDQ total-score (OR 1.1 for all). Daytime sleepiness was strongly associated with wheezing last 12 months (OR 3.4), disturbed sleep due to wheezing (OR 3.9), wheeze during or after exercise (OR 2.9), use of inhaled corticosteroids or oral leukotriene modifiers (OR 3.4) and use of bronchodilators (OR 3.9). Snoring was associated with wheezing during or after exercise (OR 2.8) and current asthma (OR 4.2).ConclusionEPT children with different types of sleep problems had more behavioural and respiratory health problems than EPT children without sleep problems.

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Children born extremely preterm had different sleeping habits at 11 years of age and more childhood sleep problems than term‐born children

Abstract: EPT children had different sleep habits to term-born controls at 11 years of age, including those with no NDD. The prevalence of sleep problems increased with increasing NDD.

Cited by 39 publications

References 28 publications

Waking up too early – the consequences of preterm birth on sleep development

Waking up too early – the consequences of preterm birth on sleep development

Premature birth and circadian preference in young adulthood: evidence from two birth cohorts

Sleep problems, behavioural problems and respiratory health in children born extremely preterm: a parental questionnaire study

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