Association between co-sleeping in the first year of life and preschoolers´ sleep patterns.

This study aimed to investigate the association between co-sleeping practiced during the first year of life and preschoolers' sleep patterns. A cross-sectional study including toddlers was designed to analyze their sleep patterns. The Brief Infant Sleep Questionnaire, validated in Spanish, was used to measure sleep quality. A latent class analysis was performed to identify qualitative subgroups in the sample and explore the effects of co-sleeping. The sleep patterns of 276 children were analyzed. A total of 181 (65%) parents reported having practiced co-sleeping with their children. The latent class analysis identified a two-class solution with two different sleep patterns. One of them showed a worse quality sleep pattern, which had a significant association with having practiced co-sleeping during the first year of life, and with the fact that they were still sleeping in the parents' room, among other characteristics related to co-sleeping and parental concerns. Breastfeeding also showed association with a worse quality sleep pattern.  Conclusion: Based on the present findings, co-sleeping during the first year of life appears to be associated with poor sleep patterns in young preschoolers. What is Known: • Co-sleeping shows benefits for infants and parents, mainly facilitating successful breastfeeding. • Literature on the effect of co-sleeping in lately sleep quality in children and their parents is very limited. What is New: • Co-sleeping practiced during the first year of life could be associated with a worse sleep pattern measured with BISQ-E tool. • A balance between the correct practice of co-sleeping and the achievement of a healthy sleep routine in preschool should probably be part of parents' health education.

Survival and factors predicting mortality in hemodialysis patients over 75 years old.

BACKGROUND: Patients starting dialysis treatments are increasingly elderly and with high morbidity and mortality. Survival and factors influencing mortality are discussed. METHODS: We studied 2,601 patients who started hemodialysis in Andalucía (Spain) between 2004 and 2007. Of these, 71 patients died in the first 90 days of hemodialysis treatment and were excluded. Three groups were considered: group A, 694 patients aged less than 60 years; group B, 1,203 patients between 60 and 75 years; and group C, 704 patients aged over 75. Survival and factors associated with mortality were studied. RESULTS: Mean survival was 46 months in group A, 41.6 in group B and 35 in the very elderly group. In univariate analysis using the Cox proportional hazards model, survival in the very elderly patients was significantly influenced by low body mass index (BMI), venous catheter as initial vascular access, arterial hypertension, congestive heart failure (CHF), late referral to nephrologist (<6 months), C-reactive protein (CRP) >10 mg/dL, serum albumin <3.5 g/dL, Kt/V (Daugirdas) <1.2 and time of dialysis session <180 minutes. In multivariate analysis, BMI, CHF, CRP, low serum albumin, Kt/V and time of dialysis session remained as independent predictors of mortality. CONCLUSIONS: Survival of the very elderly patients who remained on hemodialysis more than 90 consecutive days was poor (about 3 years). Heart failure and malnutrition/inflammation are prognostic factors related to mortality in these patients on chronic hemodialysis.