Sleep problems in children with prenatal substance exposure: the Maternal Lifestyle study

Abstract

Objective: To examine the associations between sleep problems and prenatal exposure to cocaine, opiates, marijuana, alcohol, and nicotine in children aged 1 month to 12 years.

Design: Sleep data were collected by maternal report in a prospective longitudinal follow-up of children participating in the Maternal Lifestyle multisite study.

Setting: Hospital-based research centers in Providence, Rhode Island; Miami, Florida; Detroit, Michigan; and Memphis, Tennessee.

Participants: There were 808 participants, 374 exposed to cocaine and/or opiates, and 434 comparison subjects.

Main exposure: Prenatal cocaine, opiate, marijuana, alcohol, and/or nicotine exposure.

Outcome measure: Sleep problems in early, middle, and/or late childhood, assessed as composites of maternal report items.

Results: Of the 5 substances, prenatal nicotine exposure was the only unique predictor of sleep problems (B = 0.074, R(2) change = 0.008, P = .01), with adjustment for covariates, including socioeconomic status, marital status, physical abuse, prenatal medical care, and postnatal cigarette smoke exposure.

Conclusions: Prenatal exposure to nicotine was positively associated with children's sleep problems persisting throughout the first 12 years of life. Targeting of this group of children for educational and behavioral efforts to prevent and treat sleep problems is merited given that good sleep may serve as a protective factor for other developmental outcomes.