Abstract

Background and aims Sleep stages begin to emerge from 20 weeks’ gestational age. Typical EEG changes appear at 28–30 weeks with periods of rapid eye movement (REM) and non-REM (NREM) sleep. Sleep patterns develop into near adult like patterns by 3–5 months of age. Sleep cycles (REM/NREM) are essential for infant brain development. Caffeine is routinely used for treatment and prevention of apnea of prematurity. Its effect on sleep organisation in preterm infants has been controversial. This study aimed to find differences in sleep organisation in preterm infants before and after initiation of caffeine treatment. Methods Polysomnography was recorded in 10 preterm infants [GA 27+2–36+6 (mean 30+1) weeks, BW 790–2875 (mean 1465) g] at 34–41 (avg. 36) weeks’ GA before and the day after administration of caffeine citrate loading dose (20 mg/kg). The analysis was done with visual scoring. Results Sleep quality was variable. Some infants had very interrupted sleep structure. Uninterrupted phasic REM sleep periods seemed to be more readily identified after caffeine. However, we were unable to show this by using standard indexes. There was no difference in sleep stage distribution, number of awakenings, number of sleep stage transitions or average REM period (Table 1). Conclusions We did not find any evident effect of caffeine on sleep quality in preterm infants.

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