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

Bennet, Laura; Walker, David W.; Horne, Rosemary Sylvia Claire

doi:10.1113/jp274950

Cited by 68 publications

(51 citation statements)

References 235 publications

(336 reference statements)

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“…Another possibility would be that there is a critical period in early childhood where the lack of sleep quality or quality could be particularly detrimental to various aspects of brain development, even if sleep duration normalizes later on [35] . This later hypothesis, studied in preterm children and children with obstructive sleep apnea syndrome [36], is it in accordance with the Barker hypothesis, now called the Developmental Origins of Health and Disease (DOHaD) that linked several exposures during development and latter heath troubles [37].…”

Section: Night Sleep Fragmentation and Neurocognitive Development Atmentioning

confidence: 89%

Early polysomnographic characteristics associated with neurocognitive development at 36 months of age

et al. 2019

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Background. Few studies on the relationship between sleep quantity and/or quality and cognition have been conducted among preschoolers from the healthy general population. We aimed at identifying, among 3-year-old children, early polysomnography (PSG) sleep factors associated with intelligence quotient (IQ) estimated using the Weschler Preschool and Primary Scale Intelligence-III test (WPPSI-III) and its indicators: full-scale (FISQ), verbal (VIQ), and performance (PIQ) intelligence quotients. Methods. We included full-term children from the French birth-cohort AuBE with both PSG recording at term (M0) or 6 months (M6) and available WPPSI-III scores at 3 years. Sleep and arousal characteristics of these infants were evaluated during day and night sleep periods. Relationships between IQ scores and sleep parameters were estimated using models with child as repeated effect adjusted for time (night/day), maturation (M0/M6), tobacco exposure (yes/no), anxiety depressive scores during pregnancy, maternal age, duration of breastfeeding and child gender. Results. A total of 118 PSG recordings were included, representing a total 78 unique children (38 with one PSG and 40 with 2 PSG). No correlations were found between night and day sleep durations at M0 or M6. Mean VIQ, PIQ, and FSIQ scores were within normal ranges. In multivariate models, longer sleep duration, higher sleep efficiency during day were negatively associated with all IQ scores. More frequent arousals during night were associated with lower VIQ scores. Conclusion. Early sleep characteristics such as night sleep fragmentation or longer naps could be associated with impaired cognitive function at 3 years of age.

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Section: Night Sleep Fragmentation and Neurocognitive Development Atmentioning

confidence: 89%

Early polysomnographic characteristics associated with neurocognitive development at 36 months of age

et al. 2019

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“…The two main sleep stages for the newborn are Active Sleep (AS) and Quiet Sleep (QS). Both are involved in development, maturation, and connectivity within neural networks in the brain with impacts on memorization, consolidation of learning capacities and plasticity ( 3 , 4 ). Despite the importance of sleep on neuro-development little is known about development and impact of sleep alterations in very preterm newborns.…”

Section: Introductionmentioning

confidence: 99%

Quiet Sleep Organization of Very Preterm Infants Is Correlated With Postnatal Maturation

Cailleau¹,

Weber

Cabon

et al. 2020

Front. Pediatr.

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Background: Sleep is an important determinant of brain development in preterm infants. Its temporal organization varies with gestational age (GA) and post-menstrual age (PMA) but little is known about how sleep develops in very preterm infants. The objective was to study the correlation between the temporal organization of quiet sleep (QS) and maturation in premature infants without severe complications during their neonatal hospitalization. Methods: Percentage of time spent in QS and average duration of time intervals (ADI) spent in QS were analyzed from a cohort of newborns with no severe complications included in the Digi-NewB prospective, multicentric, observational study in 2017–19. Three groups were analyzed according to GA: Group 1 (27–30 weeks), Group 2 (33–37 weeks), Group 3 (>39 weeks). Two 8-h video recordings were acquired in groups 1 and 2: after birth (T1) and before discharge from hospital (T2). The annotation of the QS phases was performed by analyzing video recordings together with heart rate and respiratory traces thanks to a dedicated software tool of visualization and annotation of multimodal long-time recordings, with a double expert reading. Results are expressed as median (interquartile range, IQR). Correlations were analyzed using a linear mixed model. Results: Five newborns were studied in each group (160 h of recording). Median time spent in QS increased from 13.0% [IQR: 13–20] to 28.8% [IQR: 27–30] and from 17.0% [IQR: 15–21] to 29.6% [IQR: 29.5–31.5] in Group 1 and 2, respectively. Median ADI increased from 54 [IQR: 53–54] to 288 s [IQR: 279–428] and from 90 [IQR: 84–96] to 258 s [IQR: 168–312] in Group 1 and 2. Both groups reach values similar to that of group 3, respectively 28.2% [IQR: 24.5–31.3] and 270 s [IQR: 210–402]. The correlation between PMA and time spent in QS or ADI were, respectively 0.73 ( p < 10 −4 ) and 0.46 ( p = 0.06). Multilinear analysis using temporal organization of QS gave an accurate estimate of PMA ( r 2 = 0.87, p < 0.001). Conclusion: The temporal organization of QS is correlated with PMA in newborns without severe complication. An automated standardized continuous behavioral quantification of QS could be interesting to monitor during the hospitalization stay in neonatal units.

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“…Infants born preterm often have extended stays in the neonatal intensive care unit (NICU), and this is associated with a number of environmental stressors; such as exposure to exogenous stimuli (e.g. light and noise), invasive and/or painful procedures and sleep deprivation [12,13], as well as various physiological stressors [14]. Studies designed to investigate the contribution of such stressors to the long-term effects of PTB are difficult, because of the presence of multiple confounders such as illness severity or length of the NICU stay.…”

Section: Introductionmentioning

confidence: 99%

Altered hypothalamic DNA methylation and stress-induced hyperactivity in a novel model of early life stress

Fitzgerald

Sinton

Wernig-Zorc

et al. 2020

Preprint

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Early life stress during childhood is associated with a number of psychiatric disorders that manifest across the life course. Preterm birth is a profound stressor, and an important cause of cognitive impairment, as well as neurodevelopmental and psychiatric disorders. However, the mechanisms that link events during the early neonatal period with later functional problems are poorly understood. We developed a novel mouse model of early life stress (modified maternal separation; MMS) with specific relevance to preterm birth (PTB) and hypothesised it would affect the hypothalamic transcriptome and DNA methylome and impact on behaviour in adulthood. MMS consisted of repeatedly stimulating pups for 1.5 hours/day, whilst separated from their mother, from postnatal day (P)4-6. 3' RNA sequencing and DNA methylation immunoprecipitation (meDIP) sequencing was performed on the hypothalamus at P6. Behaviour was assessed with the elevated plus and open field mazes, and in-cage monitoring at 3-4 months of age. Although MMS was only associated with subtle changes in gene expression there were widespread alterations in DNA methylation. Notably, differentially methylated regions were enriched for synapse-associated loci. MMS also resulted in hyperactivity in the elevated plus and open field mazes, but in-cage monitoring revealed that this was not representative of habitual hyperactivity. In conclusion we describe a novel model of early life stress with relevance to PTB, with marked effects on DNA methylation in the hypothalamus and with stress-specific hyperactivity in young adulthood. We suggest that these results have implications for the understanding of early life stress mediated effects on brain development.

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

Cited by 68 publications

References 235 publications

Early polysomnographic characteristics associated with neurocognitive development at 36 months of age

Early polysomnographic characteristics associated with neurocognitive development at 36 months of age

Quiet Sleep Organization of Very Preterm Infants Is Correlated With Postnatal Maturation

Altered hypothalamic DNA methylation and stress-induced hyperactivity in a novel model of early life stress

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