The Architecture of Early Childhood Sleep Over the First Two Years

Abstract

Introduction The architecture and function of sleep during infancy and early childhood has not been fully described in the scientific literature. The impact of early sleep disruption on cognitive and physical development is also under-studied. The aim of this review was to investigate early childhood sleep development over the first two years and its association with neurodevelopment. Methods This review was conducted according to the 2009 PRISMA guidelines. Four databases (OVID Medline, Pubmed, CINAHL, and Web of Science) were searched according to predefined search terms. Results Ninety-three studies with approximately 90,000 subjects from demographically diverse backgrounds were included in this review. Sleep is the predominant state at birth. There is an increase in NREM and a decrease in REM sleep during the first two years. Changes in sleep architecture occur in tandem with development. There are more studies exploring sleep and early infancy compared to mid and late infancy and early childhood. Discussion Sleep is critical for memory, learning, and socio-emotional development. Future longitudinal studies in infants and young children should focus on sleep architecture at each month of life to establish the emergence of key characteristics, especially from 7–24 months of age, during periods of rapid neurodevelopmental progress.

Mapping the physiological changes in sleep regulation across infancy and young childhood

“…One of the primary defining characteristics of infant sleep is the increased amount of sleep compared to adults (approximately 13-15 h per day during first few months of life), a characteristic that typically decreases with development to around 13 h per day at the age of 2 years, to 11-12 h throughout childhood, and 7-9 h in adolescence [26, 27]. Moreover, immediately after birth, sleep is broken into a large number of bouts [4], before consolidating to fewer bouts of longer length.…”

An update on diagnosis and management of obstructive sleep apnoea in the first 2 years of life

“…Each sleep cycle in neonates lasts 30-70 min with predominantly active (rapid eye movement (REM)) sleep onset, in contrast to infants older than 2 months and children who have cycles of 75-90 min duration with non-REM sleep onset [7]. Full-term neonates spend 50-80% of total sleep time in active (REM) sleep that decreases gradually to <50% by the first year of life [8]. Active (REM) sleep predisposes young infants to respiratory events [5,[9][10][11][12].…”