Prematüre Bebeklerin Gelişimsel Sürecinde Uyku, Duyusal İşlemleme ve Yürütücü İşlevler Arasındaki İlişkinin İncelenmesi: Düzeltilmiş İlk 1 Yaş

Abstract

Sırtbaş Işık, G., Investigation of the Relationship between Sleep, Sensory Processing, and Executive Functions in the Developmental Process of Premature Infants: Corrected Age of First Year, Hacettepe University, Graduate School of Health Sciences, Physical Therapy and Rehabilitation, Doctor of Philosophy Thesis, Ankara, 2023. The aim of this study is (i) to investigate the development and differences of General Movements (GMs), sleep characteristics, sensory processing, developmental assessment and executive functions, which are part of the developmental processes, in premature infants, with assessments to be made at the 3rd and 12th months, (ii) to examine the relationships between birth week and GMs, sleep, sensory processing, neurodevelopmental outcomes, and executive function (iii) to examine the relationship between sleep and sensory processing at the 3rd and 12th months, (iv) to examine the relationship between executive functions and neurodevelopmental assessments at the 12th months. 81 premature infants divided into two groups according to 32 gestational weeks, were evaluated using the GMs, a sleep questionnaire, the Infant Sensory Profile-2, and the Bayley-III when their corrected age was between 3 and 5 months. In the long-term follow-up of infants at 12 months, the executive function test, the Bayley-III, the Toddler Sensory Profile-2, and a sleep questionnaire were used. There was no difference between the results of GMs, sleep characteristics, sensory processing, and neurodevelopmental assessments used at the 3rd month of the premature groups (p>0.05). The sleep characteristics of the groups showed that the duration of staying awake at night was higher in the group born below 32 weeks, and again in this group, Bayley-III cognitive and motor results were found to be significantly lower. MOS and its sub-sections were found to be associated with sleep characteristics such as total sleep time, night awake time, sleep position, and snoring at 3 months, Bayley-III motor results at 3 and 12 months, and the results of the planning test, which is one of the executive function assessments (p<0.05). When the infants were divided into typical and atypical according to their sensory processing at 3 months, it was observed that the night and total sleep durations of infants with atypical sensory processing were significantly shorter (p<0.05). It was found that sensory processing and sleep assessment results were associated with each other at both the 3rd and 12th months, and daytime sleep duration, number of night awakenings, sleeping place, and presence of snoring were associated with typical and atypical sensory processing processes at the 12th month (p<0.05). Finally, executive functions were found to be associated with Bayley-III cognitive results at all stages, and Bayley-III motor and language results (p<0.05). With the results of our study, it is seen that the development of sleep, sensory processing, and executive function are important in addition to the motor development of premature infants in the early period. It should be considered that early spontaneous movements may contribute to the prediction of executive functions, which are determinants of cognitive development and higher cognitive processes as well as motor outcomes. In addition, it is thought that sensory processing problems may be accompanied by sleep problems, and these problems may negatively affect neurodevelopmental processes.