Children who are born with a relatively small size are more likely than their peers to have sleep difficulties or low sleep efficiency.

Sleep efficiency refers to a person's ability to fall asleep and stay asleep once the head hits the pillow.
Researchers studied 289 eight-year-old children in Finland, born healthy and full-term, to examine whether small body size at birth and prenatal tobacco or alcohol exposure predicts poor sleep and other sleep disturbances in children. Each child wore an actigraph, a watch-like device that measured sleep and activity patterns, for one week. Their parents also completed a standard questionnaire on childhood sleep disturbances.
It was found that lower the children's weight and length at birth, higher were the odds of having sleep disturbances or low sleep efficiency such as sleep-related breathing problems or nightmares. Twenty-six children had low sleep efficiency - spending roughly three-quarters or less of their time in bed actually asleep.
However, this does not mean that every child born at a relatively small size is destined for sleep difficulties. For one, birth size is partially determined by genetics, and it is possible that the findings do not pertain to newborns who are simply of smaller size.
Moreover, mothers' prenatal drinking - a habit that can impair fetal growth and development - was linked to an increased risk of childhood sleep problems. Among children whose mothers had consumed more than one drink per week during pregnancy, the risks of short sleep duration - less than 8 hours per night - and low sleep efficiency were about three times higher as compared with other children.
Prenatal smoking was not linked to sleep problems. However, this could be because few mothers in the study said they had smoked during pregnancy, limiting the study's ability to find an association.
The researchers concluded that even moderate levels of drinking during pregnancy, and birth size variations within the normal range, might affect children's sleep later on.
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