Sleep characteristics, early spontaneous movements, and developmental functioning in preterm infants in the early postnatal period


Sleep Medicine, vol.114, pp.151-158, 2024 (SCI-Expanded) identifier identifier

  • Publication Type: Article / Article
  • Volume: 114
  • Publication Date: 2024
  • Doi Number: 10.1016/j.sleep.2023.12.016
  • Journal Name: Sleep Medicine
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus, Academic Search Premier, CINAHL, MEDLINE, Psycinfo
  • Page Numbers: pp.151-158
  • Keywords: Fidgety movements, General movements, Nocturnal awakenings, Sleep duration, Sleep location, Sleep position, Snore
  • Hacettepe University Affiliated: Yes


Objective: This study aimed to investigate the following: (i) sleep characteristics in preterm infants at 9–20 weeks of corrected age, and (ii) differences in early spontaneous movements and developmental functioning results between the groups based on some sleep characteristics. Methods: Seventy-four preterm infants (36 female) were included. Sleep characteristics were assessed according to the Brief Infant Sleep Questionnaire (BISQ). The infants were divided into two groups based on total sleep duration: less than 12 h (38 infants), and 12 h and more (36 infants). Video recordings were made for the General Movements Assessment (GMA) and evaluated using the Motor Optimality Score for 3- to 5-Month-Old-Infants-Revised (MOS). Cognitive, language, and motor development were assessed using the Bayley Scales of Infant and Toddler Development, Third Edition (Bayley-III). Results: The total sleep duration of all preterm infants (mean ± SD) was 11.8 ± 3.3 h. Infants who had absent fidgety movements slept less than 12 h, and fidgety movements differed between the groups (p = 0.012). Infants who slept 12 h or more had significantly higher MOS (p = 0.041), cognitive (p = 0.002), language (p < 0.001), and motor (p = 0.002) development results. Infants who snored had lower MOS (p = 0.001), cognitive (p = 0.004), language (p = 0.002), and motor (p = 0.001) development results. Infants with fewer than three nocturnal awakenings had significantly higher Bayley-III cognitive (p = 0.007), language (p = 0.032), and motor (p = 0.005) domain results. Prone and supine sleeping positions showed higher motor domain results than lateral positions (p = 0.001). Conclusions: Sleep in preterm infants might be a key factor in early developmental functioning processes and nervous system integrity. Even in the first months of life, there are substantial differences in cognitive, language, and motor development in association with sleep characteristics.