The results regarding the association of plasma docosahexaenoic acid (DHA) levels with sleep duration conflict. This study aimed to investigate the effect of oral administration of DHA on the sleep quality of Brazilian extreme preterm infants. This cohort study is part of the Joinville Docosahexaenoic Acid Study (JoiDHA) conducted with 59 infants in Joinville, Brazil. Sleep quality was assessed using the Brief Infant Sleep Questionnaire, which consists of 12 questions about the quality of sleep the week prior to its application and was answered by the parents/guardians. Of the 59 children who participated in the study, 37 (62.7%) were supplemented with DHA and 22 (37.3%) did not receive DHA. The prevalence of poor sleep quality was higher among children with the weight status at birth <50th percentile (68.2%; p = 0.045) when compared to children ≥50th percentile. However, Poisson regression analysis showed that neither weight status at birth nor DHA use was associated with sleep quality, even after adjusting for the same variables. In summary, sleep quality 12-24 months after birth was not associated with DHA supplementation in very and extreme preterm infants. Additional studies that address the increase in DHA intake would be important for the understanding of the effect of this fatty acid on sleep quality.
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