Prenatal Origins of Poor Sleep in Children

Pesonen, Anu-Katriina; Räikkönen, Katri; Matthews, Karen A.; Heinonen, Kati; Paavonen, E. Juulia; Lahti, Jari; Komsi, Niina; Lemola, Sakari; Järvenpää, Anna‐Liisa; Kajantie, Eero; Strandberg, Timo

doi:10.1093/sleep/32.8.1086

Cited by 83 publications

(68 citation statements)

References 63 publications

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“…There is some evidence that poor sleep in children may have prenatal origins (Pesonen et al, 2009). Our results may predict sleep problems in children prenatally exposed to SSRIs.…”

Section: Discussionmentioning

confidence: 61%

“…Our results may predict sleep problems in children prenatally exposed to SSRIs. Child sleep problems, in turn, are linked to later behavioral difficulties, anxiety, depression, poor attention, and aggression (Gregory et al, 2008;Pesonen et al, 2009). Hence, future follow-up studies should focus on sleep development and neurophysiological and neuropsychological tests that challenge autonomic control and regulatory/ inhibition mechanisms in prenatally SSRI-exposed individuals.…”

Section: Discussionmentioning

confidence: 99%

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Selective Serotonin Reuptake Inhibitors Affect Neurobehavioral Development in the Human Fetus

Mulder

Ververs

Heus

et al. 2011

Neuropsychopharmacol

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The aim of this prospective study was to investigate whether selective serotonin reuptake inhibitors (SSRIs) utilized by pregnant women influence fetal neurobehavioral development. In this observational study we investigated developmental milestones of fetal behavior during the pregnancy of women with psychiatric disorders who took SSRIs throughout gestation (medicated group; n ¼ 96) or who had discontinued medication early in gestation or before conception (unmedicated group; n ¼ 37). Healthy unexposed fetuses of women without mental disorders comprised the control group (n ¼ 130). Ultrasonographic observations of fetal behavior were made three times in pregnancy (T1-T3). Effects of SSRIs were studied over a wide range of dosages (low, standard, or high) and for different drug types. Fetuses exposed to standard or high SSRI dosages compared with control, unmedicated, or low-medicated fetuses showed significantly increased motor activity at the beginning (T1) and end of the second trimester (T2). They particularly exhibited disrupted emergence of non-rapid eye movement (non-REM; quiet) sleep during the third trimester, characterized by continual bodily activity and, thus, poor inhibitory motor control during this sleep state near term (T3). The SSRI effects on the fetus were dose related, but independent of SSRI type. The results demonstrate changes in fetal neurobehavioral development associated with standard and high SSRI dosages that are observable throughout gestation. A first-choice SSRI type was not apparent. Bodily activity at high rate during non-REM sleep in SSRI-exposed fetuses is an abnormal phenomenon, but its significance for postnatal development is unclear.

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“…There is some evidence that poor sleep in children may have prenatal origins (Pesonen et al, 2009). Our results may predict sleep problems in children prenatally exposed to SSRIs.…”

Section: Discussionmentioning

confidence: 61%

Section: Discussionmentioning

confidence: 99%

Selective Serotonin Reuptake Inhibitors Affect Neurobehavioral Development in the Human Fetus

Mulder

Ververs

Heus

et al. 2011

Neuropsychopharmacol

View full text Add to dashboard Cite

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“…Therefore, the power to detect a significant difference with consideration of multiple comparisons at least in sleep macroarchitecture was adequate. We chose SE as the primary outcome, as lower birth weight is associated with lower sleep efficiency (assessed by actigraphy) in children 13 and to replicate a clinically relevant measure as normal spectral EEG values have not been established. Nonetheless, in this study, we did identify significant differences in sleep parameters with our small sample size, which marry to those previously published in preterm children, 34 and therefore, we are confident that our findings are robust.…”

Section: Limitationsmentioning

confidence: 99%

“…12 Therefore, early life programming may have significant impact on sleep. 13 Although human data are scarce, studies suggest that FGR may alter the maturation of sleep circadian rhythms in neonatal life and based on actigraphy data, sleep efficiency (SE) later in life. 14 Compounding these sleep disturbances, being born preterm, whether the infant is growth restricted or not, is associated with altered maturation of sleep in infancy.…”

Section: Introductionmentioning

confidence: 99%

Being Born Too Small and Too Early May Alter Sleep in Childhood

Yiallourou

Arena

Wallace

et al. 2017

Sleep

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Study Objectives: Fetal growth restriction (FGR) occurs in up to 10% of pregnancies and is associated with increased risk of prematurity and neurodevelopmental impairment. FGR also alters sleep-state distribution in utero and maturation in infancy. Currently, limited data on the long-term associations of FGR and childhood sleep exist. Accordingly, we assessed the associations between preterm birth and FGR and sleep in children aged 5-12 years.Methods: Seventeen children born preterm and FGR, 15 children born preterm but appropriately grown (appropriate birth weight for gestational age [AGA]), and 20 term AGA children (controls) were studied using overnight polysomnography. Sleep macroarchitecture was assessed using standard criteria, and sleep microarchitecture was assessed using spectral analysis of the electroencephalogram (C4-M1) with total, δ (0.5-3.9 Hz), θ (4.0-7.9Hz), α (8.0-11.9 Hz), σ (12.0-13.9 Hz), and β power (14.0-30 Hz) calculated.Results: For sleep macroarchitecture, preterm FGR children had higher N2% compared with term AGA children (p < .05). Preterm AGA children had reduced total sleep time, NREM%, and sleep efficiency compared with term AGA children (p < .05 for all). For sleep microarchitecture, preterm FGR children had a higher amount of total, δ and α power compared with both groups (p < .05). Sigma and β power was lowest in the preterm AGA group compared with both groups (p < .05 for both).Conclusions: Prematurity and FGR were associated with altered sleep macro-and microarchitecture measures indicative of reduced sleep quantity and quality in childhood. As sleep disturbance can affect both behavior and neurodevelopment in children, sleep in FGR and preterm children warrants further investigation. Keywords: fetal growth restriction, preterm birth, pediatric, EEG spectral analysis, sleep. Statement of SignificanceFetal growth restriction (FGR) is a major obstetric complication affecting up to 10% of pregnancies leading to increased risk of preterm birth and neurodevelopmental impairment. FGR alters the development of sleep in fetal life and infancy; however, few studies have investigated the long-term impact on sleep. This novel study assessed both sleep macro-and microarchitecture in children born preterm and FGR. Being born preterm and FGR was associated with reduced sleep quality, whereas being born preterm with an appropriate birth weight for gestational age was associated with both reduced sleep quantity and quality. This study highlights the potential need for clinical follow-up of sleep and investigation of the effects of poor sleep on neurodevelopment in this population.

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“…Detailed description of the actigraph assessment has been given before. 24 Data were scored using Actiwatch Activity and Sleep Analysis software (v 5.42) with medium sensitivity and 1-minute epochs. Sleep duration refers to actual sleeping time.…”

Section: Sleep Characteristicsmentioning

confidence: 99%

Poor Sleep and Cardiovascular Function in Children

et al. 2011

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Abstract-We investigated whether sleep quantity and quality were related to 24-hour ambulatory blood pressure and cardiovascular reactivity in children. We studied term-born, healthy 8.0-year olds (SD: 1.4 years) without sleepdisordered breathing (231 and 265 children provided valid data for analyses of ambulatory blood pressure and cardiovascular reactivity, respectively). Sleep was registered with an actigraph for 6 nights on average (SD: 1.2; range: 3 to 13 nights). Ambulatory blood pressure was measured for 24-hours (41% nonschool days) with an oscillometric device. The children underwent the Trier Social Stress Test for Children, during which blood pressure, electrocardiography, and thoracic impedance were recorded and processed offline to give measures of cardiovascular and autonomic function. Neither quantity nor quality of sleep was related to 24-hour ambulatory blood pressure or cardiovascular reactivity after accounting for major covariates (sex, age, height, body mass index, and parental education). Although lower sympathetic nervous system activation and higher cardiac activation under stress were found in the group of children who slept for short duration when they were compared with the average sleep duration group, these associations were not significant after correction for multiple testing and were not seen in linear regression models of the effects of sleep duration. 3,4 are established in adults but not in children. This is surprising given that Յ40% of all children are estimated to experience sleep problems and that the problem persists in approximately half of those affected. 5 Furthermore, elevated blood pressure (BP) and hypertension in pediatric populations are more commonly recognized than in the past. 6 BP tracks over time from childhood to adulthood, 7 and longitudinal data show that elevated BP levels in childhood are associated with hypertension, 8 manifestations of carotid atherosclerosis, 9 and coronary heart disease 10 in adulthood.Few existing studies have addressed associations between poor sleep and cardiovascular function in children. Those that have differ in their target populations and their measures of sleep and have produced contradictory results. For example, actigraphic and polysomnographic measures of low sleep efficiency (percentage of time in bed spent asleep) were associated with elevated systolic and diastolic BPs, as well as hypertension in a multiethnic sample of 13-to 16-year olds from the United States. 11 Others have relied on parent or teacher reports to assess sleep duration indirectly. In these studies, longer sleep has been associated variously with increased BP, 12 decreased BP, 13 and no change in BP 14 in groups that differed by age and ethnicity, with sample sizes ranging from 117 12 to 12 680. 13 In many of these studies, measures of resting cardiovascular function have been limited to occasional BP measurements, and we are not aware of any such studies addressing cardiovascular function in response to a challenge. This may be important, given the ab...

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Prenatal Origins of Poor Sleep in Children

Abstract: Poor sleep in children may have prenatal origins. Possible mechanisms include alcohol consumption during pregnancy and other conditions associated with small body size at birth.

Cited by 83 publications

References 63 publications

Selective Serotonin Reuptake Inhibitors Affect Neurobehavioral Development in the Human Fetus

Selective Serotonin Reuptake Inhibitors Affect Neurobehavioral Development in the Human Fetus

Being Born Too Small and Too Early May Alter Sleep in Childhood

Poor Sleep and Cardiovascular Function in Children

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