My baby was born prematurely. How will that affect her sleep?

My baby was born prematurely. How will that affect her sleep?

Generally speaking, the more premature your baby is (the earlier she was born before her due date), the higher her risk will be for sleep problems.

Your preemie (baby born prematurely, or preterm infant) probably will not start sleeping through the night as soon as other infants who were born full-term. Most infants will start to develop their own “circadian rhythm” (internal body clock that controls our sleep-wake cycle) by around 3 to 4 months of age, and this is the time when babies start distinguishing daytime from nighttime. Just as preterm infants may take longer to meet other developmental milestones like walking or talking, it will likely also take longer for your preemie’s circadian rhythm to mature. If your baby was born 2 months early, for instance, she may not start trying to sleep through the night until 5- to 6-months, since this is when her “corrected age” would be 3-4 months.

What are some potential health concerns I should pay attention to?

Premature infants are at a higher risk of having breathing problems during sleep, including both obstructive sleep apnea (OSA) and central sleep apnea. Preemies often have low muscle tone, and this can contribute to the floppiness of their airways. A “floppy airway” (i.e. laryngomalacia) is the most common cause of OSA in babies. All newborns (but especially those who were born premature) can have central apnea of infancy, which is when the part of the brain that controls how we breathe is not mature yet. Babies with central apnea of infancy will have pauses in their breathing during sleep. Although these pauses are common, definitely speak to your child’s healthcare provider if you notice breathing pauses.Premature babies are also at risk for lung problems that can make it harder to breathe during sleep, and some preemies require oxygen at home for a few months.

Preemies may also appear more jittery during sleep, and may have more awakenings. Further, they may need more sleep than other babies who were born at term. If your preemie has reflux or other feeding problems, this can impact sleep as well. As your preemie gets older, she should gradually start to “catch up” with other infants, but there can be differences between the sleep of premature and term infants even up to one year of age.

If you are concerned about your preemie’s sleep overall, or her breathing during sleep, be sure to contact her health care provider.