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 .
Perinatal Risk Factors Associated with the Obstructive Sleep Apnea Syndrome in School-Aged Children Born Preterm.
STUDY OBJECTIVES The obstructive sleep apnea syndrome ( OSAS ) is more prevalent in ex-preterm children compared to the general pediatric population . However , it is unknown whether OSAS in ex-preterm children is associated with specific perinatal risk factors . This multicenter cohort study aim ed to determine perinatal factors associated with OSAS at school age . METHODS 197 ex-preterm ( 500 - 1,250 g ) children aged 5 - 12 y who participated as neonates in a double-blind , r and omized clinical trial of caffeine versus placebo ( Caffeine for Apnea of Prematurity ) underwent comprehensive ambulatory polysomnography .  A negative binomial regression model was used to identify perinatal risk factors associated with OSAS . RESULTS 19 children had OSAS ( 9.6 % ) . Chorioamnionitis and multiple gestation were positively associated with OSAS with P values of 0.014 and 0.03 , respectively . Maternal white race ( P = 0.047 ) and maternal age ( P = 0.002 ) were negatively associated with OSAS . Other risk factors , such as birth weight , Apgar score at 5 min , antenatal corticosteroids , delivery route , and sex were not significant . CONCLUSIONS OSAS is very frequent , and is associated with chorioamnionitis and multiple gestation in ex-preterm children . Those born to older white mothers appear to be protected . We speculate that the former may be due to systemic inflammation and the latter to a higher socio-economic status . COMMENTARY A commentary on this article appears in this issue on page 721
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 .