Abstract
BackgroundPoor sleep contributes to the developmental problems seen in preterm infants. We evaluated sleep problems in preterm infants 6 months of post-gestational age using the subjective Brief Infant Sleep Questionnaire (BISQ) and objective sleep tests. We also compared the sleep of premature infants with that of full-term infants.MethodsThe study included 68 6-month-old full-term healthy infants and 191 premature infants born at <37 weeks gestation. All parents completed the BISQ-Chinese version and sleep diaries. At the same time, all premature infants were submitted to one night of polysomnography (PSG) in the sleep laboratory and also were set up with an actigraph kept for 7 days. Statistical analyses were performed using correlation coefficients and the t-test with SPSS version 18 to compare questionnaire responses with other subjective and objective measures of sleep.ResultsThe sleep problems indicated in the subjective questionnaire for the premature infants, particularly: “the nocturnal sleep duration, number of night awakenings, daytime sleep duration, duration of time with mouth breathing, and loud-noisy breathing” had significant correlations with sleep diaries, actigraphy and PSG results. The BISQ showed that duration of infant’s sleeping on one side, nocturnal sleep duration, being held to fall asleep, number of nighttime awakenings, daytime sleep duration, subjective consideration of sleep problems, loud-noisy breathing, and duration spent crying during the night were significantly different between the premature infants and the term infants. PSG confirmed the presence of a very high percentage (80.6%) of premature infants with AHI > 1 event/hour as indicated by the questionnaire.ConclusionPremature infants have more sleep problems than full-term infants, including the known risk of abnormal breathing during sleep, which has been well demonstrated already with the BISQ-Chinese (CBISQ).Electronic supplementary materialThe online version of this article (doi:10.1186/s12887-014-0303-6) contains supplementary material, which is available to authorized users.
Highlights
Poor sleep contributes to the developmental problems seen in preterm infants
The Brief infant sleep questionnaire-Chinese version (CBISQ) is derived from the Brief Infant Sleep Questionnaire (BISQ) [19] of Avi Sadeh Additional file 1
Longer “Daytime sleep duration” correlated with apnea–hypopnea index (AHI) >1; We were interested in these correlations as “mouth breathing” and “Loud-noisy breathing” are common symptoms associated with pediatric obstructive sleep apnea
Summary
Poor sleep contributes to the developmental problems seen in preterm infants. We compared the sleep of premature infants with that of full-term infants. The sleep breathing problems may be due to a lack of tone in the upper airway followed by collapse and obstruction or diaphragmatic movement dysfunction with immaturity of reflexes. Sleep-disordered breathing (SDB) is often noted in premature infants [14,15]. We made the preliminary observation that premature infants may have oral-facial developmental growth problems [18]. Such difficulties may lead to specific breathing problems during sleep and impair the sleep of the infants
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