Circadian Sleep Patterns in Toddlers Born Preterm

Abstract

Objective Children born preterm are at elevated risk for several developmental and health concerns. Early sleep patterns may be associated with these concerns. The current study assesses the associations between toddler circadian sleep/activity patterns and later developmental, behavioral, attentional, and health concerns in this at-risk population. Methods We examined circadian sleep/activity patterns at 2 years of age in 99 children born preterm. Child cognitive skills were tested at 3 years of age, and behavior, attention, and health concerns were reported at 3 and 6 years of age. First, sleep/activity data collected via actigraphy were assessed using time series analyses (TSA). For this, we assessed how each child’s sleep/activity pattern compared to a specified 24-hour circadian cycle (SCC) with an adjustment for daytime napping. Second, in a series of regression models child sleep/activity parameters from the TSA were assessed with child gender, prematurity, and family sociodemographic assets as covariates. Results Toddlers with patterns that closely aligned with the SCC had higher abbreviated IQ scores at 3 years of age. Additionally, at 6 years these children had a lower risk for illness-related medical visits. Higher toddler average activity level was associated with fewer teacher-reported ADHD symptoms and a lower risk for illness-related medical visits. Conclusion The novel approach used in this study to index child circadian patterns provides a pattern-based analysis of sleep/activity, which may prove to be developmentally consequential. With replication, these findings may help practitioners promote optimal cognitive and health development via circadian sleep supports in infants born preterm.

Mapping the physiological changes in sleep regulation across infancy and young childhood

“…Skeldon, Derks and Dijk [23] has previously found that sleep patterns in late childhood (age 10+) corresponded with a higher μ . Changes in ν νc have already been suggested in the literature [30-32], and in particular McGraw, Hoffmann, Harker and Herman [25] and Jenni, Deboer and Achermann [24] showed that the circadian rhythm in sleep is non-existent in the days soon after birth.…”

Precision caffeine therapy for apnea of prematurity and circadian rhythms: New possibilities open up

“…It is well understood that the sleep homeostasis in humans are regulated by two independent but synergistic processes (Borbély, 1982;Deboer, 2018): a Clock-dependent circadian process (Process C), controlled by the SCN circadian oscillator, determines the alternation of different sleep propensity (Cremer et al, 2016); and a Sleep-dependent homeostatic process (Process S) that is determined by the prior sleep pressure, which comes from the adenosine buildup in the basal forebrain during wakefulness (Deboer, 2018;Wong et al, 2022). However, due to the immature development of the central nervous system, especially the SCN, Process C and Process S are not stably present in preterm infants or even in term ones (Salzarulo and Fagioli, 1992;Schwichtenberg et al, 2016). As a result, preterm infants experience many sleep and wake episodes within the 24-h period, and those ultradian sleepwake rhythms persist for several months until the Process C and Process S are gradually developed (Mirmiran et al, 2003a;Cremer et al, 2016).…”