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Late Effects of Caffeine Use on Premature Children's Sleep


Prematurity is characterized by the birth of the newborn before 37 completed weeks or 259 days of gestation. Apnea of prematurity is a condition that affects preterm newborns and its main therapeutic modality is the administration of caffeine. This substance acts by competitively inhibiting adenosine receptors, especially the A1 and A2A forms, which may increase latency and decrease the quality and total sleep time. The long-term effect of caffeine administration in the neonatal period, however, still needs further understanding.


To evaluate whether the administration of caffeine in preterm newborns lately alters sleep habits and is associated with the presence of obstructive sleep apnea in children aged between 5 and 10 years old.


The parents of 84 children between 5 and 10 years of age answered the Children's Sleep Habits (CSHQ) questionnaire and the Pediatric Screening Instrument for Obstructive Sleep Apnea (FASP). This information was collected in person at the UNIFESP Preterm Clinic and remotely. The sample consisted of 50 girls and 44 boys and were categorized into term born (TG) (N=45), preterm who were not treated with caffeine (GPSC) (N=17) and preterm who were treated with caffeine (GPC) (N=22).


Using the GLM statistical test, no differences were observed in the mean scores of the CSHQ questionnaires between the three groups (GT = 46 ± 6.9, GPC = 46.7 ± 9.0, GPSC = 45.3 ± 6.5; p = 0.216) and in the FASP (GT = 1.1 ± 1.3, GPC = 1.2 ± 1.5, GPSC = 1.6 ± 1.5; p = 0.692), using the age as a covariate. Linear regression analysis in the preterm sample identified twin pregnancy ( = -1.9, p = 0.033) and the CSHQ questionnaire score ( = 0.08, p = 0.019) as predictive factors for the FASP score of preterm infants.


The partial results of the study indicate that caffeine used in the neonatal period does not affect children's sleep lately, but that the twin births of preterm children may be associated with lower FASP scores.


sleep, caffeine, preterm, children, FASP


Área Clínica


Universidade Federal de São Paulo - São Paulo - Brasil


Ana Carolina Nunes de Oliveira, Ana Paula Cruz de Castro Leão, Ana Lucia Goulart, Allan Chiaratti de Oliveira, Vânia D’Almeida