Distúrbios do sono e hábitos de sucção em crianças nascidas pré-termo: um estudo longitudinal

Abstract

Sleep disorders (SD) are conditions that disrupt normal sleep patterns and can impact overall health and quality of life across all age groups. This prospective longitudinal observational study evaluated the presence and progression of SD and nutritive and non-nutritive sucking habits in preterm children over a 20- to 37-month follow-up period in a reference center for preterm children in Belo Horizonte, Ambulatório da Criança de Risco (ACRIAR) of the Hospital das Clínicas from Universidade Federal de Minas Gerais (UFMG). The study was approved by the Institutional Ethics Committee of UFMG (protocol: 78842124.9.0000.5149). The first data collection occurred between February 2022 and February 2023 (Time 1), when the children were between 0 and 3 years old, and they were re-evaluated between September 2024 and March 2025 (Time 2), when they were between 3 and 6 years old. Parents/caregivers answered a questionnaire evaluating sociodemographic information, childbirth characteristics (gestational age, weight, height, type of delivery), feeding methods (type and duration of breastfeeding and use of a bottle), and non-nutritive sucking habits (pacifier use and thumb sucking). For SD evaluation, parents answered the Brazilian version of Brief Infant Sleep Questionnaire in Time 1 and the Brazilian version of Sleep Disturbance Scale for Children in Time 2. Descriptive and bivariate analyses were performed using the Mantel-Haenszel Chi-Square test and the Wilcoxon test (p<0.05). The sample consisted of 32 dyads parent/caregivers and children aged 3 to 6 years. SD were present in 78.8% at Time 2 and were statistically significant associated with time (p<0.001). Of the 13 cases of SD at Time 1, 84.6% maintained the diagnosis at Time 2, while 15.4% no longer met criteria. Among the 19 children without an initial diagnosis, 78.9% developed the condition at Time 2, and 21.1% remained without changes. Children diagnosed with SD at Time 1 exhibited a higher prevalence of disorders of initiating and maintaining sleep (DIMS) at Time 2 (p=0.020). The duration of breastfeeding was significantly longer at Time 2, with a mean of 11.56 months (standard deviation=13.4; median=5.50), compared to Time 1, where the mean duration was 6.59 months (standard deviation=7.48; median=4.50) (p<0.001). It was concluded that SD remained both prevalent and persistent over time, with most children initially affected remaining so at follow-up, and a substantial proportion of those initially unaffected developing the condition. Breastfeeding duration improved but remained below international recommendations.