Sleep-Wake State Organization, Neonatal Assessment and Development in Premature Infants During the First Year of Life. II.

Abstract

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.

Prediction of 3-year developmental outcomes from sleep development over the preterm period

“…The dramatic developmental decrease in active sleep over the preterm period makes possible the increases in quiet sleep and waking states Ingersoll & Thoman, 1999). Several other researchers have also found that the active sleep or its criteria are related to developmental problems in preterm and fullterm infants Whitney & Thoman, 1993) although other researchers have found that other sleeping and waking behaviors-particularly waking, crying, or quiet sleep-were better predictors of developmental outcomes (Anders et al, 1985;DiPietro & Porges, 1991;Gertner et al, 2002). However, only Anders et al and our study examined the developmental patterns of these behaviors, rather than the amounts at specific ages.…”

“…Sleep-wake measures during the preterm period-including the amount of crying, sleep cycle length, state organization quality, and amount of night sleep-predict Bayley scores during the first year (Borghese, Minard, & Thoman, 1995;DiPietro & Porges, 1991;Fajardo, Browning, Fisher, & Paton, 1992;Gertner et al, 2002). Developmental changes in the amounts of specific sleep behaviors during the first year are related to outcomes in the second year (Anders, Keener, & Kraemer, 1985;Whitney & Thoman, 1993). Further, the stability of sleep-wake patterns in the neonatal period predicts later development (Thoman, Denenberg, Sieval, Zeidner, & Becker, 1981;Whitney & Thoman, 1993).…”

Sleep Architecture in Infants of Substance-Abusing Mothers

“…The rationale for using time-lapse video recording in the home has been described previously, as have the methods of recording and scoring the videotapes for sleep and waking states Anders, Keener, & Kraemer, 1985;Anders & Sostek, 1976).…”

“…The camera was secured on a tripod that overlooked the crib and a microphone was placed nearby to record infant vocalizations. were scored according to standard methods described previously Anders, Keener & Kraemer, 1985;Anders & Sostek, 1976). All coders completed a blinded training, reliability process.…”

Caregiving and positioning effects on preterm infant states over 24 hours in a neonatal unit in Taiwan

“…Disrupting sleep and sleep cycles profoundly affects the creation of permanent neural circuits, interfering with the early process of sensory and brain development (Graven & Browne, 2008), which has sometimes led to developing attention problems in later life and adverse neurodevelopmental outcomes (O'Callaghan et al, 2010). Progressive lengthening of sleep periods was related to better mental development in later life, with long periods of uninterrupted sleep predicting better mental development at 12 months (Anders, Keener, & Kraemer, 1985). Therefore, sleep is an important determinant of infants' developmental outcomes (Arditi-Babchuk et al, 2009;A.…”