Sleep Disturbances in Children With Prenatal Alcohol Exposure
A Systematic Review & Meta-Analysis
It has long been established that prenatal alcohol exposure can lead to long-term neurological, cognitive, and physical effects that can impact the daily lives of affected children. However, recently it has been noted that children with a history of prenatal alcohol exposure also experience higher rates of sleep problems. Given this finding, this study aimed to understand the extent of these sleep disturbances, namely their timing and severity, to hopefully inform behavioural interventions to support child wellbeing.
Context
How common is prenatal alcohol exposure? What are it’s effects? And how is it related to sleep?
Prenatal alcohol exposure can result in neurological, cognitive, and physical deficits amongst affected children, affecting their daily life, education, and mental health (1-3).
Prenatal alcohol exposure is a widespread phenomenon with an estimated
%
births being affected globally (4)
In the UK, this figure rises to an estimated
%
of women consuming alcohol while pregnant, with 25% of those engaging in binge drinking (5).
The Link to Sleep
Recent research has suggested a close relationship between impaired sleep and prenatal alcohol exposure (6).
Researchers have observed that children with a history of prenatal alcohol exposure have higher rates of sleep problems than their unaffected counterparts (7).
Sleep is also known to be vital to healthy neurodevelopment, learning, emotional regulation, and memory.
… Therefore, sleep may be an important factor that mediates or exacerbates the severity of foetal alcohol spectrum disorders (2).
The Study
Findings
Types of Sleep Problems
Timing & Severity of Sleep Problems
Conclusions & Future Directions
What we learned and where do we go from here?
This study established a strong connection between prenatal alcohol exposure and sleep, underscoring the contributing role of poor sleep as a mediator and exacerbator of foetal alcohol syndrome symptoms (8).
Research Directions
Larger, longitudinal studies with more standardised sleep measurements need to be done to improve the statistical significance of these findings (8).
Practice Points
Addressing bedtime routines could be an achievable, impactful intervention in shaping sleep and wider health outcomes for children with prenatal alcohol exposure (8).
Methodological Considerations
Future studies need to consider the impact of external factors – such as family environments – modulating this relationship to better understand the problem and develop interventions (8).
Still Curious?
Access the associated publication here…
… Or contact the authors for more information.
Dr. Emma Gale
Research Fellow in Child and Adolescent Sleep Health & Sleep Research Lead
Contact at: [email protected]
Page References
- Basavarajappa BS, Subbanna S. Synaptic plasticity abnormalities in fetal alcohol spectrum disorders. Cells 2023;12(3):442.
- Maya-Enero S, Ramis-Fernandez SM, Astals-Vizcaino M, García-Algar O. Neurocognitive and behavioral profile of fetal alcohol spectrum disorder. Anales de Pediatría (English Edition) 2021;95(3):208. e1–e9.
- Jacobson SW, Hoyme HE, Carter RC, Dodge NC, Molteno CD, Meintjes EM, et al. Evolution of the physical phenotype of fetal alcohol spectrum disorders from childhood through adolescence. Alcohol Clin Exp Res 2021;45(2):395–408.
- Popova S, Lange S, Probst C, Gmel G, Rehm J. Estimation of national, regional, and global prevalence of alcohol use during pregnancy and fetal alcohol syndrome: a systematic review and meta-analysis. Lancet Global Health 2017;5(3):e290–9.
- McQuire C, Mukherjee R, Hurt L, Higgins A, Greene G, Farewell D, et al. Screening prevalence of fetal alcohol spectrum disorders in a region of the United Kingdom: a population-based birth-cohort study. Prev Med 2019;118:344–51.
- Wilson DA, Sullivan RM, Smiley JF, Saito M, Raineki C. Developmental alcohol
exposure is exhausting: sleep and the enduring consequences of alcohol exposure during development. Neurosci Biobehav Rev 2024;158:105567.
- Gerstner T. Sleep disturbances, epilepsy, EEG findings and clinical function in Norwegian children with fetal alcohol spectrum disorder. 2024.
- Gale EL, Hunt CA. Sleep disturbance in children with prenatal alcohol exposure: a systematic review and meta-analysis. Sleep Med Rev. 2025;84:102186