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Routine del sonno e risvegli notturni nei bambini durante i primi due anni di vita
Italian children early sleep habits and awakenings: nascita cohort study
Giulia Segre1, Aantonio Clavanna1, Elisa Roberti1, Rita Campi1, Gherardo Rapisardio2, Maurizio Bonati1
1Dipartimento di Epidemiologia Medica, Laboratorio di Epidemiologia dell'Età Evolutiva, Istituto Mario Negri-IRCCS, Milano
2Centro Touchpoints Brazelton, Roma
Giugno 2024 - pagg. 365 -370 | DOI: 10.53126/MEB43365
Abstract
Background - Previous studies analyzed the characteristics and prevalence of sleep problems in Italian children. However, less attention is shed on the factors involved in sleep disturbances in the first two years of life.
Aims - To provide a developmental trajectory of Italian infants’ sleep patterns during the first two years of life and to analyze what factors affect it most over time.
Materials and Methods - Data for this study were collected within the NASCITA cohort. During the well-child visits conducted at 6, 12, and 24 months, paediatricians asked parents to report if their children had any sleep disturbances, particularly frequent night awakenings. Univariate and multivariable analyses were performed to test the association between child and family variables and the likelihood of frequent awakenings.
Results - 2,973 toddlers were included in this study; 875 (29.4%) toddlers presented frequent awakenings in at least one visit (peak of prevalence of 19.8% at 12 months). Bed-sharing (adjusted OR 2.53; 95% CI: 2.05-3.12) and living in the North of Italy (aOR 2.25; 95% CI:1.80-2.81) were the variables more strongly associated with an increased likelihood of frequent awakenings in the binomial logistic regression, while sleeping alone was associated with a decreased chance (aOR 0.62; 95% CI 0.45-0.89).
Conclusion - The current study identifies some early predictors of frequent awakenings during the first two years of life. Since optimal sleep practices in children are essential for their development, paediatric care practices must define and integrate early effective interventions.
Aims - To provide a developmental trajectory of Italian infants’ sleep patterns during the first two years of life and to analyze what factors affect it most over time.
Materials and Methods - Data for this study were collected within the NASCITA cohort. During the well-child visits conducted at 6, 12, and 24 months, paediatricians asked parents to report if their children had any sleep disturbances, particularly frequent night awakenings. Univariate and multivariable analyses were performed to test the association between child and family variables and the likelihood of frequent awakenings.
Results - 2,973 toddlers were included in this study; 875 (29.4%) toddlers presented frequent awakenings in at least one visit (peak of prevalence of 19.8% at 12 months). Bed-sharing (adjusted OR 2.53; 95% CI: 2.05-3.12) and living in the North of Italy (aOR 2.25; 95% CI:1.80-2.81) were the variables more strongly associated with an increased likelihood of frequent awakenings in the binomial logistic regression, while sleeping alone was associated with a decreased chance (aOR 0.62; 95% CI 0.45-0.89).
Conclusion - The current study identifies some early predictors of frequent awakenings during the first two years of life. Since optimal sleep practices in children are essential for their development, paediatric care practices must define and integrate early effective interventions.
Riassunto
Background - Precedenti studi hanno analizzato le caratteristiche e la prevalenza dei problemi del sonno nei bambini italiani. Meno attenzione viene però prestata ai fattori coinvolti nei disturbi del sonno nei primi due anni di vita.
Obiettivi - Fornire una traiettoria di sviluppo del ritmo del sonno dei bambini italiani durante i primi due anni di vita e analizzare quali fattori lo influenzano maggiormente nel tempo.
Materiali e metodi - I dati per questo studio sono stati raccolti all'interno della coorte NASCITA. Durante le visite ai bambini sani effettuate a 6, 12 e 24 mesi, i pediatri hanno chiesto ai genitori di segnalare se i loro bambini presentavano disturbi del sonno, in particolare risvegli notturni frequenti. Sono state eseguite analisi univariate e multivariate per testare l'associazione tra le variabili del bambino e della famiglia e la probabilità di risvegli frequenti.
Risultati - in questo studio sono stati inclusi 2.973 bambini; 875 (29,4%) bambini hanno presentato risvegli frequenti in almeno una visita (picco di prevalenza del 19,8% a 12 mesi). La condivisione del letto (OR aggiustato 2,53; IC 95%: 2,05-3,12) e il vivere nel Nord Italia (aOR 2,25; IC 95%: 1,80-2,81) erano le variabili più fortemente associate ad una maggiore probabilità di risvegli frequenti nei soggetti regressione logistica binomiale, mentre dormire da soli era associato a una diminuzione della probabilità (aOR 0,62; IC al 95% 0,45-0,89).
Conclusione - Il presente studio identifica alcuni predittori precoci di risvegli frequenti durante i primi due anni di vita. Poiché le pratiche ottimali del sonno nei bambini sono essenziali per il loro sviluppo, interventi precoci ed efficaci devono essere definiti e integrati nelle pratiche di assistenza pediatrica.
Obiettivi - Fornire una traiettoria di sviluppo del ritmo del sonno dei bambini italiani durante i primi due anni di vita e analizzare quali fattori lo influenzano maggiormente nel tempo.
Materiali e metodi - I dati per questo studio sono stati raccolti all'interno della coorte NASCITA. Durante le visite ai bambini sani effettuate a 6, 12 e 24 mesi, i pediatri hanno chiesto ai genitori di segnalare se i loro bambini presentavano disturbi del sonno, in particolare risvegli notturni frequenti. Sono state eseguite analisi univariate e multivariate per testare l'associazione tra le variabili del bambino e della famiglia e la probabilità di risvegli frequenti.
Risultati - in questo studio sono stati inclusi 2.973 bambini; 875 (29,4%) bambini hanno presentato risvegli frequenti in almeno una visita (picco di prevalenza del 19,8% a 12 mesi). La condivisione del letto (OR aggiustato 2,53; IC 95%: 2,05-3,12) e il vivere nel Nord Italia (aOR 2,25; IC 95%: 1,80-2,81) erano le variabili più fortemente associate ad una maggiore probabilità di risvegli frequenti nei soggetti regressione logistica binomiale, mentre dormire da soli era associato a una diminuzione della probabilità (aOR 0,62; IC al 95% 0,45-0,89).
Conclusione - Il presente studio identifica alcuni predittori precoci di risvegli frequenti durante i primi due anni di vita. Poiché le pratiche ottimali del sonno nei bambini sono essenziali per il loro sviluppo, interventi precoci ed efficaci devono essere definiti e integrati nelle pratiche di assistenza pediatrica.
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Corrispondenza: maurizio.bonati@ricercaeprtica.it