Sleep and emotional functioning in premature children: A systematic literature review

Abstract

Sleep, as the predominant behavioral state in newborns, especially in preterm infants, represents a key component for development. It is suggested that preterm children exhibit greater sleep difficulties compared to full-term children, as well as a disproportionately higher prevalence of emotional deficits. Due to the limited research on sleep and emotional functioning in the population of preterm children, particularly their interconnections, the primary aim of this systematic literature review was to explore existing scientific research on sleep and emotional functioning in preterm children, with particular focus on emotional regulation. Additionally, we aimed to examine potential links between these two constructs in this population. As a secondary objective, the review also considered studies addressing any interventions related to sleep or emotional functioning in preterm children. The results of the systematic literature review did not allow for definite conclusions regarding sleep in preterm compared to full-term children from a qualitative perspective. On the other hand, an increased presence of emotional and behavioral difficulties in this population was clearly identified. An effective intervention for regulating emotions and sleep was found to be the kangaroo care, as well when combined with music intervention. Breastfeeding also demonstrated positive effects on behavioral and emotional functioning. There appears to be a tendency for sleep problems to manifest more noticeably in late compared to early childhood. This finding highlighted the importance of long-term monitoring of this population through later childhood, adolescence, and even adulthood to better understand the long-term consequences of preterm birth on sleep and emotional functioning. Further research is essential for developing interventions that could mitigate or prevent long-term negative effects on sleep and emotional well-being associated with preterm birth.

Keywords: Emotion regulation; Emotional functioning; Preterm children; Sleep.