Volume 29, Issue 4 (Iran South Med J 2026)                   Iran South Med J 2026, 29(4): 207-219 | Back to browse issues page


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Taherahmadi H, Khamenehpour K, Razzaghi A, Shirmohammadi S. Investigation of Factors Affecting Sleep Disorders in Infants Less Than One Year of Age with Gastroesophageal Reflux Disease Referred to the Qazvin Sleep Clinic in 2024-2025. Iran South Med J 2026; 29 (4) :207-219
URL: http://ismj.bpums.ac.ir/article-1-2643-en.html
1- Department of Pediatrics, Arak University of Medical Sciences, Arak, Iran
2- Clinical Research Development Unit of Advanced Medicine, Qazvin University of Medical Sciences, Qazvin, Iran , kh.khamenehpour@qums.ac.ir
3- Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran
4- Clinical Research Development Unit of Advanced Medicine, Qazvin University of Medical Sciences, Qazvin, Iran
Abstract:   (305 Views)
Background: Sleep disorders in infants significantly affect their physical and mental development. Since gastroesophageal reflux disease (GERD) is known to affect sleep quality, this study aimed to investigate the factors associated with sleep disorders in infants with GERD.
Materials and Methods: This descriptive-analytical cross-sectional study was conducted between 2024 and 2025 on infants under 12 months old diagnosed with GERD. Data were collected using a demographic information questionnaire and Infant Sleep Questionnaire (ISQ). Statistical analysis included descriptive statistics, chi-square tests, independent t-tests, and linear regression analysis using SPSS (version 27). A p-value of <0.05 was considered statistically significant.
Results: A total of 261 infants were screened and GERD was diagnosed in 75 (28.73%). Of the 75 infants, 54 (72%) had sleep disturbances (mean infant nighttime sleep duration: 7.9 ± 1.9 hours). Fourteen (25.9%, n=54) breastfed infants and forty (74.1%, n=54) formula-fed infants had sleep disturbances (p=0.008). Infants with GERD who had sleep disturbances had lower mean infant sleep score (45.9 ± 18.3, p < 0.001), parental perception of infant sleep (51.4 ± 21.4, p=0.004), and total sleep questionnaire score (53.13 ± 0.7, p < 0.001).
Conclusion: Sleep disturbances were observed in half of the infants with GERD. Type of feeding, mean sleep score, parental perception of sleep, and total score of the sleep questionnaire were significantly associated with the occurrence of sleep disorders in infants with GERD.
 
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Original: Original | Subject: infants
Received: 2026/05/6 | Accepted: 2026/08/2 | Published: 2026/09/26

References
1. Robinson-Shelton A, Malow BA. Sleep disturbances in neurodevelopmental disorders. Curr Psychiatry Rep 2016; 18(1): 6. [DOI]
2. Sadeh A, Juda‐Hanael M, Livne‐Karp E, et al. Low parental tolerance for infant crying: an underlying factor in infant sleep problems? J Sleep Res 2016; 25(5): 501-507. [DOI]
3. Ahn Y, Williamson AA, Seo H-J, et al. Sleep patterns among South Korean infants and toddlers: global comparison. J Korean Med Sci 2016; 31(2): 261-269. [DOI]
4. Khamenehpour K, Zeidi IM, Shahsavari S, et al. Effective factors related to sleep disorder in infants under 12 months old. Sleep Sci 2025; 18(2): e190-e196. [DOI]
5. Ehsan Z, Glynn EF, Hoffman MA, et al. Small sleepers, big data: leveraging big data to explore sleep-disordered breathing in infants and young children. Sleep 2021; 44(2): zsaa176. [DOI]
6. Mersky JP, Lee CP, Gilbert RM, et al. Prevalence and correlates of maternal and infant sleep problems in a low-income US sample. Matern Child Health J 2020; 24(2): 196-203. [DOI]
7. Lestari H, Wahani AMI, Wilar R, et al. Risk factors for sleep problems in infants. Paediatr Indones 2020; 60(4): 186-191. [DOI]
8. McNamara F, Sullivan CE. Sleep-disordered breathing and its effects on sleep in infants. Sleep 1996; 19(1): 4-12. [DOI]
9. Pappa A, Muschaweck M, Wenzl TG. Change of sleep stage during gastroesophageal reflux in infants. Children (Basel) 2023; 10(5): 836. [DOI]
10. Kurin M, Shibli F, Kitayama Y, et al. Sorting out the relationship between gastroesophageal reflux disease and sleep. Curr Gastroenterol Rep 2021; 23(9): 15. [DOI]
11. Shelly CE, Filatava EJ, Thai J, et al. Elevated intestinal inflammation in preterm infants with signs and symptoms of gastroesophageal reflux disease. Biol Res Nurs 2021; 23(3): 524-532. [DOI]
12. Kesavelu D, Franklyn N, Venkatraghavan C, et al. Prevalence and severity of gastroesophageal reflux disease in indian children presenting with symptoms of acid reflux: a real-world evidence study. Turk Arch Pediatr 2025; 60(3): 341-343. [DOI]
13. Ravel A, Mircher C, Rebillat AS, et al. Feeding problems and gastrointestinal diseases in Down syn-drome. Arch Pediatr 2020; 27(1): 53-60. [DOI]
14. Smits MJ, van Wijk MP, Langendam MW, et al. Association between gastroesophageal reflux and pathologic apneas in infants: a systematic review. Neurogastroenterol Motil 2014; 26(11): 1527-1538. [DOI]
15. Ammari M, Djeddi D, Leke A, et al. Relationship be-tween sleep and acid gastrooesophageal reflux in neonates. J Sleep Res 2012; 21(1): 80-86. [DOI]
16. Ikobah J. Gastro-oesophageal reflux disease in sub-Saharan African children. Niger J Paediatr 2025; 52(2): 88-100. [Article]
17. Klapp JM, Hall TA, Riley AR, et al. Sleep disturbances in infants and young children following an acquired brain injury. J Clin Sleep Med 2022; 18(10): 2387-2395. [DOI]
18. Shanmugapriya S, Saravanan A, Shuruthi S, et al. Association of gastroesophageal reflux disease with anxiety, depression, and sleep disorders. J Med Sci 2021; 41(1): 9-16. [DOI]
19. Ghaem M, Armstrong K, Trocki O, et al. The sleep patterns of infants and young children with gastro‐oesophageal reflux. J Paediatr Child Health 1998; 34(2): 160-163. [DOI]
20. Mutluer T, Karakoc Demirkaya S, Abali O. Assessment of sleep problems and related risk factors observed in T urkish children with A utism spectrum disorders. Autism Res 2016; 9(5): 536-542. [DOI]
21. Cassanello P, Díez-Izquierdo A, Gorina N, et al. Adaptation and study of the measurement properties of a sleep questionnaire for infants and preschool children. An Pediatr (Engl Ed) 2018; 89(4): 230-237. [DOI]
22. Del-Ponte B, Xavier MO, Bassani DG, et al. Validity of the brief infant sleep questionnaire (BISQ) in Brazilian children. Sleep Med 2020; 69: 65-70 [DOI]
23. Yazdi M, Bemanalizadeh M, Kelishadi R. Persian version of brief infant sleep questionnaire (BISQ): a psychometric evaluation. BMC Pediatr 2024; 24(1): 181. [DOI]
24. Khaksar S. Maternal Stress and Sleep of Hospitalized Children: The Effects of a Using Video Call Intervention to Improve Family-Centered Care. JPEN 2022; 9(1): 65-75. (Persian) [DOI]
25. Khaksar S, Maroufi M, Kalhor F. A persian transla-tion of “brief infant sleep questionnaire revised (BISQ-R)” for assessment of sleep in infants and toddlers: a pilot study. J Ped Perspect 2022; 10(1): 15296-15303. [DOI]
26. Mindell JA, Gould RA, Tikotzy L, et al. Norm-referenced scoring system for the brief infant sleep questionnaire–revised (BISQ-R). Sleep Med 2019; 63: 106-114. [DOI]
27. Machado R, Woodley FW, Skaggs B, et al. Gastroesophageal reflux causing sleep interruptions in infants. J Pediatr Gastroenterol Nutr 2013; 56(4): 431-435. [DOI]
28. Vandenplas Y, Deneyer M, Verlinden M, et al. Gastroesophageal reflux incidence and respiratory dysfunction during sleep in infants: treatment with cisapride. J Pediatr Gastroenterol Nutr 1989; 8(1): 31-36. [DOI]
29. Krishnan V, Collop NA. Gender differences in sleep disorders. Curr Opin Pulm Med 2006; 12(6): 383-389. [DOI]
30. Bruni O, Baumgartner E, Sette S, et al. Longitudinal study of sleep behavior in normal infants during the first year of life. J Clin Sleep Med 2014; 10(10): 1119-1127. [DOI]
31. Wake M, Morton-Allen E, Poulakis Z, et al. Prevalence, stability, and outcomes of cry-fuss and sleep problems in the first 2 years of life: prospective community-based study. Pediatrics 2006; 117(3): 836-842. [DOI]
32. Fleming PJ, Blair PS, Pollard K, et al. Pacifier use and sudden infant death syndrome: results from the CESDI/SUDI case control study. Arch Dis Child 1999; 81(2): 112-116. [DOI]
33. Li DK, Willinger M, Petitti DB, et al. Use of a dummy (pacifier) during sleep and risk of sudden infant death syndrome (SIDS): population based case-control study. BMJ 2006; 332(7532): 18-22. [DOI]
34. North K, Fleming P, Golding J, et al. Pacifier use and morbidity in the first six months of life. Pediatrics 1999; 103(3): e34. [DOI]
35. Zimmerman E, Forlano J, Gouldstone A. Not all pacifiers are created equal: a mechanical examination of pacifiers and their influence on suck patterning. Am J Speech Lang Pathol 2017; 26(4): 1202-1212. [DOI]
36. Quillin SI. Infant and mother sleep patterns during 4th postpartum week. Issues Compr Pediatr Nurs 1997; 20(2): 115-123. [DOI]
37. van Lee L, Meijer‐Krommenhoek Y, He T, et al. Sleep duration among breastfed, goat milk‐based or cow's milk‐based infant formula‐fed infants: Post hoc analyses from a double‐blind RCT. J Pediatr Gastroenterol Nutr 2025; 80(3): 482-489. [DOI]
38. da Silveira KSR, Serra-Negra JM, Prado IM, et al. Sleep disturbances are associated with feeding practices and age in preterm infants. Sleep Med 2023; 111: 2-8. [DOI]
39. Quante M, McGee GW, Yu X, et al. Associations of sleep-related behaviors and the sleep environment at infant age one month with sleep patterns in in-fants five months later. Sleep Med 2022; 94: 31-37. [DOI]
40. Cheung CH, Bedford R, Saez De Urabain IR, et al. Daily touchscreen use in infants and toddlers is associated with reduced sleep and delayed sleep on-set. Sci Rep 2017; 7(1): 46104. [DOI]
41. Kahn M, Barnett N, Glazer A, et al. Sleep and screen exposure across the beginning of life: deciphering the links using big-data analytics. Sleep 2021; 44(3): zsaa158. [DOI]
42. Hunsley M, Thoman EB. The sleep of co‐sleeping infants when they are not co‐sleeping: Evidence that co‐sleeping is stressful. Dev Psychobiol 2002; 40(1): 14-22. [DOI]
43. Thunström M. Severe sleep problems among infants in a normal population in Sweden: prevalence, severity and correlates. Acta Paediatr 1999; 88(12): 1356-1363. [DOI]
44. Moon RY, Darnall RA, Feldman-Winter L, et al. SIDS and other sleep-related infant deaths: evidence base for 2016 updated recommendations for a safe infant sleeping environment. Pediatrics 2016; 138(5): e20162940. [DOI]
45. Galbally M, Lewis AJ, McEgan K, et al. Breastfeeding and infant sleep patterns: an A ustralian population study. J Paediatr Child Health 2013; 49(2): E147-E152. [DOI]
46. Brown A, Harries V. Infant sleep and night feeding patterns during later infancy: association with breastfeeding frequency, daytime complementary food intake, and infant weight. Breastfeed Med 2015; 10(5): 246-252. [DOI]

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