Sleep changes in response to environmental pressures and the needs of individuals. The adaptability of sleep is noticeable following largely stressful or adverse events, and is understood to facilitate recovery. Rapid changes in sleep occur in-utero, during the days following birth, and across the first few postnatal years. These rapid changes are considered adaptive and indicative of normal and healthy development. Elective surgical intervention, such as circumcision, may influence the organization and quality of sleep during this developmentally sensitive period. Neonates undergoing circumcision, a prevalent procedure in the U.S. (American Academy of Pediatrics Circumcision Policy Statement [AAP], 1999, 2005, 2012), also are at risk for operative stress or postoperative pain. Changes in the sleep organization of neonates have been observed following circumcision, but are not consistent. In these analyses, I specifically evaluated changes in infant sleep cycles surrounding circumcision from pre-existing data. These data present a unique opportunity to characterize sleep in relation to circumcision because they were collected prior to routine use of anesthetic or analgesic. Infants were compared on sleep state organization, determined using Motility Monitoring recordings of infant movement and respiration. Quiet sleep of circumcised infants decreased and transitional sleep marginally increased from before circumcision to after circumcision. Respiratory rate during quiet sleep increased among both circumcision and control groups. The lapse from active sleep to quiet sleep decreased for uncircumcised males and did not change for the circumcised group. Male neonates appear to demonstrate Quiet and Transitional sleep trends from pre-to post-circumcision, but ultimately neither of their changes differed in comparison to a group of combined females and uncircumcised males. It is plausible that test outcomes did not reach statistical significance because of differences in the distribution of infant sex across groups, or because of small sample size. Although no causal relation between circumcision and sleep measures can be inferred from these data, the changes in sleep organization that were demonstrated by circumcised males in this study should be investigated among infants receiving procedural anesthesia, but who do not typically receive analgesic intervention to mediate postoperative pain's effect on sleep during recovery after circumcision. Table of Contents Introduction…………………………………………………………………………………………………1 Infant Sleep Architecture and Behavioral Assessment…………………………………………….2 Circumcision……………………………………………………………………………………….4 Changes in Infant Sleep Organization Following Physical Trauma or Stress……………………..6

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Purpose From an anthropological perspective of hominin communication, the human auditory system likely evolved to enable special sensitivity to sounds produced by the vocal tracts of human conspecifics whether attended or passively heard. While numerous electrophysiological studies have used stereotypical human-produced verbal (speech voice and singing voice) and nonverbal vocalizations to identify human voice–sensitive responses, controversy remains as to when (and where) processing of acoustic signal attributes characteristic of “human voiceness” per se initiate in the brain. Method To explore this, we used animal vocalizations and human-mimicked versions of those calls (“mimic voice”) to examine late auditory evoked potential responses in humans. Results Here, we revealed an N1b component (96–120 ms poststimulus) during a nonattending listening condition showing significantly greater magnitude in response to mimics, beginning as early as primary auditory cortices, preceding the time window reported in previous studies that revealed species-specific vocalization processing initiating in the range of 147–219 ms. During a sound discrimination task, a P600 (500–700 ms poststimulus) component showed specificity for accurate discrimination of human mimic voice. Distinct acoustic signal attributes and features of the stimuli were used in a classifier model, which could distinguish most human from animal voice comparably to behavioral data—though none of these single features could adequately distinguish human voiceness. Conclusions These results provide novel ideas for algorithms used in neuromimetic hearing aids, as well as direct electrophysiological support for a neurocognitive model of natural sound processing that informs both neurodevelopmental and anthropological models regarding the establishment of auditory communication systems in humans. Supplemental Material https://doi.org/10.23641/asha.12903839

Purpose: Pain is amplified following partial sleep deprivation. Pain has not been evaluated after sleep interruption, when total sleep time is preserved. Sleep interruption, also called sleep fragmentation, is ecologically relevant because it is caused by common sleep disorders such as Obstructive Sleep Apnea [OSA], Upper Airway Resistance Syndrome [UARS] and Periodic Limb Movements Disorder [PLMD]. The Sleep Continuity Hypothesis posits that the restorative effects of sleep are related to sleep quality in addition to quantity. With this study, my goal was to evaluate whether sleep fragmentation affected pain threshold and/or tolerance by systematically fragmenting the sleep of otherwise healthy adults. Methods: Twelve adult female participants without chronic pain or evidence of a sleep disorder underwent a 14-day protocol. Sleep was monitored using actigraphy throughout the study. Participants completed daily morning and evening reaction time tasks to evaluate changes in attention. To measure changes in pain threshold (when a stimulus becomes painful) and tolerance (when a stimulus is no longer tolerable), a pressure-pain task was administered in-lab by a researcher. This test occurred a total of eight times, morning and evening. Participants spent the eighth, ninth and 13th nights in-lab. Night eight was for acclimatization to the research facility [BASE]. To compare pain after experimental sleep fragmentation (every five minutes; [FRAG]) with pain after sham [SHAM], these conditions were assigned pseudo-randomly to nights nine and 13. Three nights of recovery sleep outside the lab occurred between SHAM and FRAG nights. Results: Sleep interruptions were induced at a rate of 5.2 times per hour, on average, without changing participants' total sleep time. Stage two sleep proportion was higher on fragmentation night. Lapses in vigilance were lower after BASE than other nights. The slowest 10% of reaction times were slower after SHAM than BASE. Overall, reaction time did not reliably differ as a result of fragmentation. Neither pain threshold nor pain tolerance differed as a function of experimental condition. Conclusions: Systematic sleep fragmentation, particularly of stage two sleep, did not affect reaction time (a measure of sustained attention) or pressure pain (threshold or tolerance). Reaction time was not related to individual-level changes in fragmentation or pain. Future work should aim to establish the minimal fragmentation that engenders a clinical effect (without concomitant hypoxemia) to inform clinical definitions of fragmentation severity.