872-876 Leitner

The purpose of this study was to characterize the sleep patterns of children with intrauterine growth retardation, known to be at risk for neurodevelopmental disorders, and seek a possible correlation with behavior, concentration, and attention problems. The sleep patterns of 26 children with intrauterine growth retardation aged 4 to 7 years were compared with those of 47 control children using activity monitors (actigraphs), In addition, data were collected from the parents regarding sleep habits, behavior, concentration, and attention. Children with intrauterine growth retardation aged 4 to 7 years were found to have a tendency toward poorer quality of sleep than their matched controls. This inclination was statistically significant only for one sleep measure, the true sleep time. A tendency toward increased fragmentation of sleep, prolonged wakes, and decreased sleep efficiency, although not statistically significant in this study, was demonstrated. Our results showed that 58% of the children with intrauterine growth retardation, compared with 40% of the children in the control group, could be defined as “poor sleepers” (sleep efficiency lower than 90 or three or more waking episodes per night). This disturbed sleep profile is probably an integral part of the neurodevelopmental profile typical of these atrisk children. No significant correlations were found between sleep quality and behavior, concentration, and attention problems. (J Child Neurol 2002;17:872–876). Received July 8, 2002. Received revised August 19, 2002. Accepted for publication August 19, 2002. From The Institute for Child Development and Pediatric Neurology Unit (Drs Leitner, Bloch, Neuderfer, and Harel), Tel Aviv Sourasky Medical Center affiliated with Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Department of Psychology (Dr Sadeh and Mr Tikotzky), Tel Aviv University, Ramat Aviv, Tel Aviv, Israel. *The first two authors should be regarded as first authors who contributed equally to this work. This study was made possible by a grant from the Gulton Foundation, New York. Address correspondence to Dr Yael Leitner, The Institute for Child Development, Beit Habriut Strauss, 14 Balfour St., Tel Aviv 65211, Israel. Tel: 972-54-305626; fax: 972-9-9518981; e-mail: [email protected]. ciation between sleep disturbances and behavioral and attention disorders known to exist in this high-risk group. To date, no published data exist regarding sleep disorders in children with intrauterine growth retardation. The paucity of data on sleep in infants and children results from the low availability and high cost of the conventional method of sleep study, that is, polysomnography. This examination takes place in a sleep laboratory and involves connection to monitors, interfering with the child’s sleep and decreasing the reliability of the test. In contrast to polysomnography, actigraphy (activity-based monitoring) provides a continuous, nonintrusive way of measuring sleep-wake patterns, performed at the child’s home. It has been established as a valid and reliable technique of assessing sleep-wake patterns.19–21 No special installation is required (ie, it is simply attached to the child’s wrist). The actigraph provides data on sleep schedule, night arousals, and sleep quality. This method was used to examine, in a more natural manner, the sleep pattern of children with intrauterine growth retardation in comparison with normal control children.