Pulmonary and Sleep Medicine, University of Washington, Seattle Children's Hospital, Seattle, Washington, USA.
Department of Psychology, Saint Joseph's University, Philadelphia, Pennsylvania, USA.
J Sleep Res. 2023 Aug;32(4):e13813. doi: 10.1111/jsr.13813. Epub 2022 Dec 25.
Sleep disturbances including bedtime problems and night awakenings are common during infancy. Polysomnography during the first years of life is performed mainly to rule out sleep-disordered breathing; however, sleep-related movement disorders can constitute a significant contributor to sleep disruption in this age group. Almost no studies have investigated the presence of periodic limb movements during sleep and underlying iron deficiency in infants, especially in those born preterm or with an underlying genetic syndrome. In this retrospective study we included infants 3-24 months referred for polysomnography for snoring or frequent nocturnal awakenings. All children had bloodwork (ferritin and haemoglobin) conducted within 3 months of the overnight sleep study. We studied 79 infants, including 31 (39.2%) full-term without diagnosis, 10 (12.7%) born premature, 16 (20.3%) with Down syndrome, 15 (19.0%) with Prader-Willi syndrome, and the remaining seven (8.9%) had various disorders. Compared with those with Down syndrome, Prader-Willi syndrome and full-term infants, those with prematurity showed a statistically significant elevated periodic limb movement index and lower ferritin levels than the other groups. Both ferritin (r = -0.18) and haemoglobin (r = -0.30) were negatively correlated with periodic limb movement index; however, this correlation reached statistical significance only for haemoglobin. Iron deficiency is associated with increased periodic leg movements during sleep in infants. Infants with prematurity had higher periodic limb movement index and lower ferritin levels than infants with Down syndrome, Prader-Willi syndrome or without diagnosis.
睡眠障碍包括入睡问题和夜间觉醒，在婴儿期很常见。生命最初几年的多导睡眠图主要用于排除睡眠呼吸障碍；然而，睡眠相关运动障碍可能是该年龄段睡眠中断的重要原因。几乎没有研究调查过婴儿睡眠中周期性肢体运动的存在和潜在的缺铁情况，尤其是那些早产儿或有潜在遗传综合征的婴儿。在这项回顾性研究中，我们纳入了因打鼾或频繁夜间觉醒而接受多导睡眠图检查的 3-24 个月大的婴儿。所有儿童在进行夜间睡眠研究的 3 个月内均进行了血液检查（铁蛋白和血红蛋白）。我们研究了 79 名婴儿，其中 31 名（39.2%）为足月无诊断，10 名（12.7%）为早产儿，16 名（20.3%）为唐氏综合征，15 名（19.0%）为 Prader-Willi 综合征，其余 7 名（8.9%）有各种疾病。与唐氏综合征、Prader-Willi 综合征和足月婴儿相比，早产儿的周期性肢体运动指数明显升高，铁蛋白水平明显降低。铁蛋白（r=−0.18）和血红蛋白（r=−0.30）与周期性肢体运动指数呈负相关；然而，只有血红蛋白的相关性达到统计学意义。缺铁与婴儿睡眠中周期性腿部运动增加有关。与唐氏综合征、Prader-Willi 综合征或无诊断的婴儿相比，早产儿的周期性肢体运动指数更高，铁蛋白水平更低。
