title: Sleep and breathing in premature infants at 6 months post-natal age.
abstract: BACKGROUND
  Poor sleep contributes to the developmental problems seen in preterm infants. We evaluated sleep problems in preterm infants 6 months of post-gestational age using the subjective Brief Infant Sleep Questionnaire (BISQ) and objective sleep tests. We also compared the sleep of premature infants with that of full-term infants.
  
  
  METHODS
  The study included 68 6-month-old full-term healthy infants and 191 premature infants born at <37 weeks gestation. All parents completed the BISQ-Chinese version and sleep diaries. At the same time, all premature infants were submitted to one night of polysomnography (PSG) in the sleep laboratory and also were set up with an actigraph kept for 7 days. Statistical analyses were performed using correlation coefficients and the t-test with SPSS version 18 to compare questionnaire responses with other subjective and objective measures of sleep.
  
  
  RESULTS
  The sleep problems indicated in the subjective questionnaire for the premature infants, particularly: "the nocturnal sleep duration, number of night awakenings, daytime sleep duration, duration of time with mouth breathing, and loud-noisy breathing" had significant correlations with sleep diaries, actigraphy and PSG results. The BISQ showed that duration of infant's sleeping on one side, nocturnal sleep duration, being held to fall asleep, number of nighttime awakenings, daytime sleep duration, subjective consideration of sleep problems, loud-noisy breathing, and duration spent crying during the night were significantly different between the premature infants and the term infants. PSG confirmed the presence of a very high percentage (80.6%) of premature infants with AHI > 1 event/hour as indicated by the questionnaire.
  
  
  CONCLUSIONS
  Premature infants have more sleep problems than full-term infants, including the known risk of abnormal breathing during sleep, which has been well demonstrated already with the BISQ-Chinese (CBISQ).
authors.affiliation: Sleep Center and Child Psychiatry Department, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan. yushuhuang1212@gmail.com.
authors.forename: Yu-Shu
authors.initials: YS
authors.lastname: Huang
authors.affiliation: Clinical Neurosciences Department, Faculdade Medicina Lisboa, University of Lisbon, Lisbon, Portugal. teresapaiva0@gmail.com.
authors.forename: Teresa
authors.initials: T
authors.lastname: Paiva
authors.affiliation: Division of Pediatric Neonatology, Department of Pediatrics, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan. jeff0724@gmail.com.
authors.forename: Jen-Fu
authors.initials: JF
authors.lastname: Hsu
authors.affiliation: Sleep Center and Child Psychiatry Department, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan. jamesno999@hotmail.com.
authors.forename: Ming-Chun
authors.initials: MC
authors.lastname: Kuo
authors.affiliation: Stanford University Sleep Medicine Division, 450 Broadway Street, MC 5704, Redwood City, CA 94063, Stanford, USA. cguil@stanford.edu.
authors.forename: Christian
authors.initials: C
authors.lastname: Guilleminault
mesh_terms: D003448:Crying; D005260:Female; D005500:Follow-Up Studies; D005865:Gestational Age; D006801:Humans; D007223:Infant; D007234:Infant, Premature; D008297:Male; D009058:Mouth Breathing / Q000503:physiopathology; D012120:Respiration Disorders / Q000503:physiopathology*; D012893:Sleep Wake Disorders / Q000503:physiopathology*; D011795:Surveys and Questionnaires