2nd Department of Pediatrics, School of Medicine, Aristotle University of Thessaloniki, University General Hospital AHEPA, Thessaloníki, Greece.
World J Pediatr. 2019 Jun;15(3):209-218. doi: 10.1007/s12519-019-00240-8. Epub 2019 Mar 4.
Sleep undergoes changes from birth to adulthood, while sleep disorders are associated with various cognitive deficiencies in childhood. In parallel, prematurity is known to predispose to poor neurodevelopmental outcomes. Our aim is to provide literature data about factors influencing sleep in the premature infants and sleep outcomes in this population.
A systematic review was conducted using a variety of health-related databases. Original research papers were considered and no year-of-publication restriction was placed.
In total, 22 articles fulfilled our selection criteria. Available studies present remarkable heterogeneity in terms of methodological design. Compared to full term, premature infants exhibit significant differences in sleep structure, which mainly include differences in electroencephalographic spectral values, in total sleep time and in arousal threshold. Furthermore, prematurity seems to be a risk factor of sleep breathing disorders in childhood and adolescence. Data about the effect of methylxanthines and the environment of neonatal intensive care unit is controversial. With regard to the impact of prematurity-related sleep disorders on future neurodevelopment, available research papers are generally few.
The alterations in sleep patterns are an outcome of prematurity (immaturity of nervous system) as well as of postnatal factors and comorbidities. Sleep problems in this population of infants seems to be a missing piece of the puzzle of impaired neurodevelopment. Future studies should focus on interventions to improve sleep hygiene and limit neurodevelopmental problems.
睡眠会随着个体从婴儿期到成年期的成长而发生变化，而睡眠障碍与儿童时期的各种认知缺陷有关。同时，早产儿已知易发生神经发育不良的后果。我们的目的是提供有关早产儿睡眠的影响因素以及该人群的睡眠结果的文献数据。
我们使用各种健康相关数据库进行了系统综述。考虑了原始研究论文，且没有对发表年份进行限制。
共有 22 篇文章符合我们的选择标准。现有研究在方法设计方面存在显著的异质性。与足月儿相比，早产儿的睡眠结构存在显著差异，主要表现在脑电图频谱值、总睡眠时间和觉醒阈值方面的差异。此外，早产儿似乎是儿童和青少年睡眠呼吸障碍的危险因素。关于甲基黄嘌呤和新生儿重症监护病房环境的数据存在争议。关于与早产儿相关的睡眠障碍对未来神经发育的影响，现有研究论文通常较少。
睡眠模式的改变是由早产儿（神经系统不成熟）以及出生后因素和合并症引起的。该婴儿人群的睡眠问题似乎是神经发育受损这一拼图中缺失的一块。未来的研究应集中于改善睡眠卫生和限制神经发育问题的干预措施。
