SLEEP - Prenatal Origins of Poor Sleep in Children

VOLUME 32, ISSUE 08

PRENATAL ORIGINS OF POOR SLEEP IN CHILDREN
Prenatal Origins of Poor Sleep in Children

Anu-Katriina Pesonen, PhD¹; Katri Räikkönen, PhD¹; Karen Matthews, PhD²; Kati Heinonen, PhD¹; Juulia E.Paavonen, MD, PhD¹; Jari Lahti, MA¹; Niina Komsi, MA¹; Sakari Lemola, PhD¹; Anna-Liisa Järvenpää, MD, PhD¹; Eero Kajantie, MD, PhD³; Timo Strandberg, MD, PhD⁴

¹Department of Psychology and Institute of Clinical Medicine, University of Helsinki, Helsinki, Finland; ²Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA; ³National Public Health Institute, Finland; ⁴Department of Health Sciences/Geriatrics, University of Oulu and Oulu University Hospital, Unit of General Practice, Oulu, Finland

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Study Objectives: We examined whether small body size at birth and prenatal tobacco or alcohol exposure predict poor sleep and more sleep disturbances in children.

Design: An epidemiologic cohort study of 289 eight-year-old children born at term.

Measurements and results: Sleep duration and efficiency were measured by actigraphy for 7 consecutive nights (mean = 7.1, SD = 1.2). We used both continuous measures of poor sleep and binary variables of short sleep and low sleep efficiency ( ≤ 10^th percentiles). Parents completed the Sleep Disturbance Scale for Children. Lower birth weight and shorter length at birth were associated with lower sleep efficiency. For every 1-SD decrease in weight and length at birth, the odds for low sleep efficiency increased by 1.7 fold (95% confidence interval [CI]: 1.1 to 2.7) and 2.2 fold (95% CI: 1.3 to 3.7), respectively. For every 1-SD decrease in ponderal index at birth, the risk of parent-reported sleep disorders increased by 1.4 fold (95% CI: 1.0 to 2.0). Moreover, children exposed prenatally to alcohol had a 2.9-fold (95% CI: 1.1 to 7.6) and 3.6-fold (95% CI: 1.3 to 10.0) increased risk for having short sleep and low sleep efficiency, respectively. The associations were not confounded by sex, gestational length, prenatal and perinatal complications, body mass index at 8 years, asthma, allergies, or parental socioeconomic status.

Conclusions: Poor sleep in children may have prenatal origins. Possible mechanisms include alcohol consumption during pregnancy and other conditions associated with small body size at birth.

Keywords: Body size at birth, epidemiological, actigraphy, alcohol, tobacco

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