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 .
Conclusions 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 .
Background 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 .
Effect of Prone and Supine Position on Sleep, Apneas, and Arousal in Preterm Infants
OBJECTIVE . Prematurely born compared with term born infants are at increased risk of sudden infant death syndrome , particularly if slept prone . The purpose of this work was to test the hypothesis that preterm infants with or without bronchopulmonary dysplasia being prepared for neonatal unit discharge would sleep longer and have less arousals and more central apneas in the prone position . METHODS . This was a prospect i ve observational study in a tertiary NICU . Twenty-four infants ( 14 with bronchopulmonary dysplasia ) with a median gestational age of 27 weeks were studied at a median postconceptional age of 37 weeks .  Video polysomnographic recordings of 2-channel electroencephalogram , 2-channel electro-oculogram , nasal airflow , chest and abdominal wall movements , limb movements , electrocardiogram , and oxygen saturation  were made in the supine and prone positions , each position maintained for 3 hours . The duration of sleep , sleep efficiency ( total sleep time/total recording time ) , and number and type of apneas , arousals , and awakenings were recorded . RESULTS . Overall , in the prone position , infants slept longer , had greater sleep efficiency ( 89.5 % vs 72.5 % ) , and had more central apneas ( median : 5.6 vs 2.2 ) , but fewer obstructive apneas ( 0.5 vs 0.9 ) . The infants had more awakenings ( 9.7 vs 3.5 ) and arousals per hour ( 13.6 vs 9.0 ) when supine . There were similar findings in the bronchopulmonary dysplasia infants . CONCLUSIONS . Very prematurely born infants studied before neonatal unit discharge sleep more efficiently with fewer arousals and more central apneas in the prone position , emphasizing the importance of recommending supine sleeping after neonatal unit discharge for prematurely born infants
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 .
Conclusions 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 .
Background 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 .