Summary: Two groups of infants (40 normal full-term, 24 prematurely born infants) were matched on conceptional age and were studied at seven ages during the first year of life, All-night time-lapse video somnography was obtained in the home at 2, 4, 8, 20, 24, 36, and 52 weeks of age. The developmental course of sleep-wake state proportions, sleep onset indices, and special variables assessing temporal organization are compared. Age-appropriate developmental norms for sleep-wake state assessment during the first year of life are presented, using video somnography. In general, sleep-wake state ontogenesis is comparable in the two groups. The premature group is more variable from one age to the next, even though both groups demonstrate significant individual stability of some sleepwake variables over the first year of life. Key Words: Sleep-wake state-Gestational age-Active sleep-Quiet sleep.Sleep difficulties in infants from birth to 3 years have become one of the most common problems of pediatric practice. Usually the disturbances are short -lived and probably without long-term consequences, although sleep habits of young infants may reflect longer lasting temperamental characteristics or aspects of dyadic interaction that herald later childhood and adult sleep patterns. Given the prevalence of the problem in the pediatric age group, it is surprising how little longitudinal data exist describing the ontogenesis of sleep-wake patterns in normal infants.Cross-sectional studies during infancy and childhood have repeatedly confirmed that developmental changes of REM sleep, NREM sleep, and waking do occur (1)(2)(3)(4)(5)(6)(7)(8)(9). The studies confirm that, by and large, the REM state predominates in immature infants and declines during maturation, sleep onsets from wakefulness are to the REM state during the early months of life and to the NREM state later, diurnal influences on REM/NREM organization during the night emerge gradually, and poor epoch-by-epoch coordination of physiological systems results in immature sleep state organization (indeterminate states) in

Summary: Twenty four premature infants were evaluated in their homes at seven ages during the first year of life to determine whether sleep-wake state organization was related to either neonatal assessment or short-term developmental outcome measures. A model assessing environmental and biological influences on the maturational course of selected sleep-wake state parameters was also evaluated. Sleepwake state variables and neonatal assessment items were related to each other, and both predicted developmental quotients at 6 months and 1 year of age. Concordance was present primarily in the domain of motor activities. Waking motor behaviors and motor activity in sleep seem to independently reflect an infant's level of developmental organization. Individual sleep-wake state variables were influenced by both biological and environmental factors during maturation. The developmental course of quiet sleep is primarily biologically determined, as evidenced by its relationship to the infant's birth status (gestational age or birth weight); the infant's behavior that results in being taken from the crib during the night, and the course of his/her sleep that occurs between midnight and morning are dependent on both biological factors (perhaps infant irritability), and postbirth experiences (perhaps the caregiver'S response to infant irritability). The course of active sleep and wakefulness are dependent solely on environmental influences, and not on maturity at birth.

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Controversies about temperamental assessments raise questions about whether questionnaires, which assess parental perceptions of temperament, validly measure within-child characteristics. Thirty-eight couples were recruited from childbirth classes for a short-term longitudinal study. Mother's perceptions of activity, rhythmicity and mood were moderately stable from late pregnancy to 6 mth postnatally. Only father's perceptions of activity were stable during this time. Infants rated by parents as difficult on the Carey Infant Temperament Questionnaire at 6 mth were rated by observers as less responsive while being fed by their mothers. Results are discussed in the context of influences on parental perceptions of temperament.

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