早产儿学龄前睡眠问题研究进展

张启飞; 赵峰; 江海宁; 于瀛均; 方向兰; 谢多双

doi:10.11852/zgetbjzz2025-0311

PDF(614 KB)

中国儿童保健杂志 ›› 2026, Vol. 34 ›› Issue (8) : 936-940. DOI: 10.11852/zgetbjzz2025-0311

综述

早产儿学龄前睡眠问题研究进展

张启飞^1,2, 赵峰¹, 江海宁², 于瀛均², 方向兰², 谢多双³

作者信息 +

Sleep disturbances in preschool children born prematurely

ZHANG Qifei^1,2, ZHAO Feng¹, JIANG Haining², YU Yingjun², FANG Xianglan², XIE Duoshuang³

Author information +

文章历史 +

摘要

早产儿学龄前睡眠问题对其神经发育、认知功能及家庭生活质量具有显著影响。与足月儿相比,早产儿在学龄前期更容易出现睡眠问题,且可能会持续至学龄期乃至成年。本文系统梳理了早产儿学龄前睡眠障碍的分类、发生机制及对神经发育的长期影响,并基于现有证据,提出多维度改善策略,以期为改善早产儿学龄前睡眠质量提供科学指导。

Abstract

Sleep disturbances in preschool children born prematurely significantly impact their neurodevelopment, cognitive function, and family quality of life.Compared with full-term infants, preterm infants are more likely to experience sleep disturbances during the preschool period, and these issues may persist into school age and even adulthood.This review systematically synthesizes current evidence regarding the classification, underlying pathogenic mechanisms of sleep disorders in this vulnerable population. Furthermore, we examine the long-term consequences of atypical sleep patterns on neurodevelopment and propose multidimensional, evidence-based intervention strategies, aiming to provide targeted clinical guidance for improving sleep quality in preschool-age preterm children.

导出引用

张启飞, 赵峰, 江海宁, 于瀛均, 方向兰, 谢多双. 早产儿学龄前睡眠问题研究进展[J]. 中国儿童保健杂志. 2026, 34(8): 936-940 https://doi.org/10.11852/zgetbjzz2025-0311

ZHANG Qifei, ZHAO Feng, JIANG Haining, YU Yingjun, FANG Xianglan, XIE Duoshuang. Sleep disturbances in preschool children born prematurely[J]. Chinese Journal of Child Health Care. 2026, 34(8): 936-940 https://doi.org/10.11852/zgetbjzz2025-0311

中图分类号： R179

参考文献

[1] Ohuma EO, Moller AB, Bradley E, et al. National, regional, and global estimates of preterm birth in 2020, with trends from 2010: A systematic analysis[J]. Lancet, 2023, 402(10409): 1261-1271.
[2] 张悦, 邵洁, 吴婕翎. 高危儿规范化健康管理专家共识[J]. 中国儿童保健杂志, 2023, 31(6): 581-585, 622.
Zhang Y, Shao J, Wu JL. Expert consensus on the standardized health management of at-risk children[J]. Chin J Child Health Care, 2023, 31(6): 581-585, 622. (in Chinese)
[3] Park J. Sleep promotion for preterm infants in the NICU[J]. Nurs Women's Health, 2020, 24(1): 24-35.
[4] Tamir S, Dye TJ, Witt RM. Sleep and circadian disturbances in children with neurodevelopmental disorders[J]. Semin Pediatr Neurol, 2023,48: 101090.
[5] Varma P, Conduit R, Junge M, et al. Examining sleep and mood in parents of children with sleep disturbances[J]. Nat Sci Sleep, 2020,12: 865-874.
[6] Harskamp-van Ginkel MW, Kool RE, van Houtum L, et al. Potential determinants during 'the first 1 000 days of life'of sleep problems in school-aged children[J]. Sleep Med, 2020,69: 135-144.
[7] Zenteno AD, Alviéa CC, Carrasco RP, et al. Trastornos respiratorios del sueéo en pediatría: Avances en tiempos pandémicos[J]. Rev Chil Enferm Respir, 2023, 39(4): 295-300.
[8] Sırtbaşık G, Porsnok D, Yardımcı-Lokmanoğlu BN, et al. Sleep characteristics, early spontaneous movements, and developmental functioning in preterm infants in the early postnatal period[J]. Sleep Med, 2024,114: 151-158.
[9] Crump C, Friberg D, Li X, et al. Preterm birth and risk of sleep-disordered breathing from childhood into mid-adulthood[J]. Int J Epidemiol, 2019, 48(6): 2039-2049.
[10] Brockmann PE, Poggi H, Martinez A, et al. Perinatal antecedents of sleep disturbances in schoolchildren[J]. Sleep, 2020, 43(8): zsaa021.
[11] Stangenes KM, Fevang SK, Grundt J, et al. Sleep problems from age two to five years and neurological outcome in children born extremely preterm: A cross-sectional study[J]. Front Pediatr, 2025,13: 1562630.
[12] Lam LT, Lam MK. Sleep disorders in early childhood and the development of mental health problems in adolescents: A systematic review of longitudinal and prospective studies[J]. Int J Environ Res Public Health, 2021, 18(22): 11782.
[13] Asaka Y, Mitani Y, Ohta H, et al. Preterm toddlers have low nighttime sleep quality and high daytime activity[J]. Sci Rep, 2022,12: 20032.
[14] Bondopadhyay U, Diaz-Orueta U, Coogan AN. A systematic review of sleep and circadian rhythms in children with attention deficit hyperactivity disorder[J]. J Atten Disord, 2022, 26(2): 149-224.
[15] Govindan RB, Andescavage NN, Basu S, et al. Circadian rhythm development in preterm infants. The role of postnatal versus postmenstrual age[J]. Early Hum Dev, 2024,196: 106084.
[16] Uchitel J, Vanhatalo S, Austin T. Early development of sleep and brain functional connectivity in term-born and preterm infants[J]. Pediatr Res, 2022, 91(4): 771-786.
[17] Biggs SN, Meltzer LJ, Tapia IE, et al. Sleep/wake patterns and parental perceptions of sleep in children born preterm[J]. J Clin Sleep Med, 2016, 12(5): 711-717.
[18] Matsangas P, Shattuck NL. Circadian rhythmicity and 24/7 operations[J]. Curr Sleep Med Rep, 2025,11: 14.
[19] Brumbaugh JE, Conrad AL, Lee JK, et al. Altered brain function, structure, and developmental trajectory in children born late preterm[J]. Pediatr Res, 2016, 80(2): 197-203.
[20] Bruni O,Breda M,Mammarella V,et al.Sleep and circadian disturbances in children with neurodevelopmental disorders[J].Nat Rev Neurol.2025,21(2):103-120.
[21] Bamalan OA, Moore MJ, Al Khalili Y. Physiology, serotonin[M]. In:StatPearls. Treasure Island (FL): StatPearls Publishing, July 30, 2023.
[22] 何海燕, 王睿, 宁曼, 等. 家庭环境因素和父母教养方式对学龄前儿童睡眠行为的影响[J]. 中国儿童保健杂志, 2021, 29(9): 996-999, 1025.
He HY, Wang R, Ning M, et al. Effects of family environment and parental rearing styles on sleep behaviors of preschool children[J]. Chin J Child Health Care, 2021, 29(9): 996-999, 1025. (in Chinese)
[23] Fang Y, Luo J, Boele M, et al. Parent, child, and situational factors associated with parenting stress: A systematic review[J]. Eur Child Adolesc Psychiatry, 2024, 33(6): 1687-1705.
[24] 黄燕, 雷玥, 黄垂灿, 等. 海口市学龄前儿童屏幕暴露影响因素及其对夜间睡眠的影响分析[J]. 中国社会医学杂志, 2024, 41(5): 569-574.
Huang Y, Lei Y, Huang CC, et al. Analysis of screen exposure chronotype, influencing factors and its impact on sleep of preschool children in Haikou City[J]. Chin J Soc Med, 2024, 41(5): 569-574. (in Chinese)
[25] Zhao T, Xuan K, Liu H, et al. Sleep disturbances and correlates among a sample of preschool children in rural China[J]. Sleep Biol Rhythms, 2021, 20(1): 123-136.
[26] Fischer S, Schumacher T, Knaevelsrud C, et al. Genes and hormones of the hypothalamic-pituitary-adrenal axis in post-traumatic stress disorder. What is their role in symptom expression and treatment response[J]. J Neural Transm (Vienna), 2021, 128(9): 1279-1286.
[27] Naing L, Hassen S, Sharbini S, et al. The relationship between the use of screen-based devices and self-reported sleep quality in adolescents aged 13 - 19 years in Brunei[J]. BMC Public Health, 2024, 24(1): 3270.
[28] 张婷, 谢传波, 周丽, 等. 广东省早产儿学龄前期睡眠特点分析[J]. 中国学校卫生, 2019, 40(10): 1464-1466, 1470.
Zhang T, Xie CB, Zhou L, et al. Characteristics of sleep among Chinese preschool children born preterm[J]. Chin J Sch Health, 2019, 40(10): 1464-1466, 1470. (in Chinese)
[29] Hoge MK, Heyne E, De Freitas Nicholson T, et al. Vulnerable child syndrome in the neonatal intensive care unit: A review and a new preventative intervention with feasibility and parental satisfaction data[J]. Early Hum Dev, 2021,154: 105283.
[30] Takahashi M, Wang G, Adachi M, et al. Differences in sleep problems between Japanese and Chinese preschoolers: A cross-cultural comparison within the Asian region[J]. Sleep Med, 2018,48: 42-48.
[31] Martin CA, Papadopoulos N, Rinehart N, et al. Associations between child sleep problems and maternal mental health in children with ADHD[J]. Behav Sleep Med, 2021, 19(1): 12-25.
[32] Schultz LF, Kroll C, Constantino B, et al. Association of maternal depression and anxiety symptoms with sleep duration in children at preschool age[J]. Matern Child Health J, 2020, 24(1): 62-72.
[33] Almadhoob A, Ohlsson A. Sound reduction management in the neonatal intensive care unit for preterm or very low birth weight infants[J]. Cochrane Database Syst Rev, 2020, 2020(1): CD010333.
[34] Skelton H, Psaila K, Schmied V, et al. Systematic review of the effects of positioning on nonautonomic outcomes in preterm infants[J]. J Obstet Gynecol Neonatal Nurs, 2023, 52(1): 9-20.
[35] Lewis P, Wild U, Pillow JJ, et al. A systematic review of chronobiology for neonatal care units: What we know and what we should consider[J]. Sleep Med Rev, 2024,73: 101872.
[36] 凌雅, 章新琼, 肖娟. 以用户为中心的早产儿家庭支持护理微信小程序的开发与应用[J]. 中国护理管理, 2024, 24(3): 393-397.
Ling Y, Zhang XQ, Xiao J. Development and implementation of WeChat mini program for family support care of premature infants based on user-centered design[J]. Chin Nurs Manag, 2024, 24(3): 393-397. (in Chinese)
[37] Sentner T, Wang X, de Groot ER, et al. The Sleep Well Baby project: An automated real-time sleep-wake state prediction algorithm in preterm infants[J]. Sleep, 2022, 45(10): zsac143.
[38] 杨月欣, 王光亚, 潘兴昌. 中国食物成分表[M]. 6版. 北京: 北京大学医学出版社, 2018: 45-52.
Yang YX, Wang GY, Pan XC. China food composition tables[M]. 6th ed. Beijing: Peking University Medical Press, 2018: 45-52.(in Chinese)
[39] Martini S, Meneghin F, Aceti A, et al. Effect of different tube feeding methods on gastroesophageal reflux features in preterm infants: A pH-impedance monitoring study[J]. Eur J Pediatr, 2024, 183(11): 4755-4762.
[40] Gloston GF, Ward KC, Rodriguez-Torres GC, et al. Integrating assessment of circadian rhythmicity to improve treatment outcomes for circadian rhythm sleep-wake disorders: Updates on new treatments[J]. Curr Sleep Med Rep, 2025, 11(1): 8.
[41] Carmassi C, Palagini L, Caruso D, et al. Systematic review of sleep disturbances and circadian sleep desynchronization in autism spectrum disorder: Toward an integrative model of a self-reinforcing loop[J]. Front Psychiatry, 2019,10: 366.
[42] Khirani S, Griffon L, Dosso M, et al. Does therapeutic CPAP pressure correlate with OSA severity in children?[J]. Sleep Med, 2025,129: 89-93.