THE SLEEP PATTERNS OF INFANTS AND YOUNG-CHILDREN WITH GASTROESOPHAGEAL REFLUX

Objective: Sleep disturbance in gastro-oesophageal reflux disease (COR D) in infants and young children has not been systematically studied n or has this manifestation been compared with population norms. Methods : Sleep patterns of 102 infants and children aged 1 to 36 months with and without GORD, defined by pH monitoring, were analysed using the sa me questionnaire as in recent studies of normal sleep behaviour in thi s age range. Main outcome measures included time taken to settle at ni ght, the number of night time wakenings requiring parental interventio n, day time sleep patterns and parents problems with their childs' sle ep behaviour. Results: Compared with the population norms (n=3102), th ose with CORD (n=76) had greater prevalence of night time waking >3/ni ght (50% vs 13% aged 3-12 months; 60% vs 10% aged 12-24 months, P<0.00 1), requirement of parental intervention (82% vs 55% aged 3-12 months, P<0.05; 92% vs 55% aged 12-24 months, P < 0.001), significantly delay ed onset of sleeping through the night, and greater prevalence of dayt ime sleep beyond 24 months. Similar but less striking differences were seen comparing those with (n = 76) and without GORD (n = 26). Conclus ions: Sleep interruption occurs more frequently in infants and childre n with CORD than population norms. Objective evaluation of infants and children with sleep disturbance after the age of 3 months may avoid u nnecessary over or under diagnosis of GORD. Systematic investigation o f the contribution of CORD to sleep disturbance in infants and young c hildren is warranted.