Sleep Disturbances and Their Associations with Child and Family Quality of Life in School-Aged Children Born Before 32 Weeks of Gestation: A Cross-Sectional Comparative Study

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Aim: To compare sleep disturbances, quality of life, and physical activity levels between school-aged children born before 32 weeks of gestation and healthy term-born peers, and to examine the associations of sleep disturbances with physical activity and quality of life in both children and their parents. Methods: This cross-sectional comparative study included 55 children aged 7–8 years who were born before 32 weeks of gestation and 55 healthy term-born controls. Controls were frequency matched to the preterm group by age and sex to ensure comparable distributions of these key demographic characteristics. Sleep disturbances were assessed using the Sleep Disturbance Scale for Children (SDSC), children’s quality of life using the Pediatric Quality of Life Inventory (PedsQL), parental quality of life using the PedsQL Family Impact Module, and physical activity using the Physical Activity Questionnaire for Older Children (PAQ-C). Results: The total SDSC score was significantly higher in preterm children than in the control group (p = 0.044). Significant differences were observed particularly in the subscales assessing difficulties initiating and maintaining sleep (p = 0.007) and sleep–wake transition disorders (p = 0.019). Regarding children’s quality of life, only the emotional functioning subscale was significantly poorer in the preterm group (p = 0.002). For parental quality of life, the emotional functioning (p = 0.01) and daily activities (p = 0.04) subscales were significantly impaired, whereas physical activity levels were comparable between the groups. No significant associations were found between sleep disturbance and either children’s quality of life or physical activity in the preterm group. In multivariable analysis, children’s quality of life and total sleep disturbance score were identified as independent predictors of parental quality of life. Conclusions: School-aged children born before 32 weeks of gestation experience a greater burden of sleep problems, particularly disturbances involving sleep initiation and maintenance and the transition between sleep and wakefulness. Sleep disturbances were independently associated with poorer parental quality of life, regardless of children’s quality of life. These results emphasize the need to incorporate regular evaluation of sleep and a family-centered perspective into the long-term care of children born preterm.

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