title: Prenatal origins of poor sleep in children.
abstract: OBJECTIVE
  We examined whether small body size at birth and prenatal tobacco or alcohol exposure predict poor sleep and more sleep disturbances in children.
  
  
  METHODS
  An epidemiologic cohort study of 289 eight-year-old children born at term.
  
  
  RESULTS
  Sleep duration and efficiency were measured by actigraphy for 7 consecutive nights (mean = 7.1, SD = 1.2). We used both continuous measures of poor sleep and binary variables of short sleep and low sleep efficiency ( < or = 10th percentiles). Parents completed the Sleep Disturbance Scale for Children. Lower birth weight and shorter length at birth were associated with lower sleep efficiency. For every 1-SD decrease in weight and length at birth, the odds for low sleep efficiency increased by 1.7 fold (95% confidence interval [CI]: 1.1 to 2.7) and 2.2 fold (95% CI: 1.3 to 3.7), respectively. For every 1-SD decrease in ponderal index at birth, the risk of parent-reported sleep disorders increased by 1.4 fold (95% CI: 1.0 to 2.0). Moreover, children exposed prenatally to alcohol had a 2.9-fold (95% CI: 1.1 to 7.6) and 3.6-fold (95% CI: 1.3 to 10.0) increased risk for having short sleep and low sleep efficiency, respectively. The associations were not confounded by sex, gestational length, prenatal and perinatal complications, body mass index at 8 years, asthma, allergies, or parental socioeconomic status.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Psychology, University of Helsinki, Helsinki, Finland.
authors.forename: Anu-Katriina
authors.initials: AK
authors.lastname: Pesonen
authors.forename: Katri
authors.initials: K
authors.lastname: Räikkönen
authors.forename: Karen
authors.initials: K
authors.lastname: Matthews
authors.forename: Kati
authors.initials: K
authors.lastname: Heinonen
authors.forename: Juulia E
authors.initials: JE
authors.lastname: Paavonen
authors.forename: Jari
authors.initials: J
authors.lastname: Lahti
authors.forename: Niina
authors.initials: N
authors.lastname: Komsi
authors.forename: Sakari
authors.initials: S
authors.lastname: Lemola
authors.forename: Anna-Liisa
authors.initials: AL
authors.lastname: Järvenpää
authors.forename: Eero
authors.initials: E
authors.lastname: Kajantie
authors.forename: Timo
authors.initials: T
authors.lastname: Strandberg
mesh_terms: D001724:Birth Weight; D001827:Body Height; D049628:Body Size; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D063647:Fetal Alcohol Spectrum Disorders / Q000175:diagnosis / Q000453:epidemiology; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D018670:Monitoring, Ambulatory; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology; D012307:Risk Factors; D012893:Sleep Wake Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology; D013548:Sweden