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Very preterm infants show earlier emergence of 24-hour sleep-wake rhythms compared to term infants


Guyer, Caroline; Huber, Reto; Fontijn, Jehudith; Bucher, Hans Ulrich; Nicolai, Heide; Werner, Helene; Molinari, Luciano; Latal, Beatrice; Jenni, Oskar G (2014). Very preterm infants show earlier emergence of 24-hour sleep-wake rhythms compared to term infants. Early Human Development, 91(1):37-42.

Abstract

BACKGROUND: Previous studies show contradictory results about the emergence of 24-h rhythms and the influence of external time cues on sleep-wake behavior in preterm compared to term infants.
AIMS: To examine whether very preterm infants (<32weeks of gestational age) differ in their emergence of the 24-h sleep-wake rhythm at 5, 11 and 25weeks corrected age compared to term infants and whether cycled light conditions during neonatal intermediate care affects postnatal 24-h sleep-wake rhythms in preterm infants. Study design: Prospective cohort study with nested interventional trial. Subjects: 34 preterm and 14 control term infants were studied. During neonatal hospitalization, preterm infants were randomly assigned to cycled light [7am-7pm lights on, 7pm-7am lights off, n=17] or dim light condition [lights off whenever the child is asleep, n=17]. Outcome measures: Sleep and activity behavior recorded by parental diary and actigraphy at 5, 11 and 25weeks corrected age.
RESULTS: Sleep at nighttime and the longest consolidated sleep period between 12pm-6am was longer (mixed model analysis, factor group: p=0.02, resp. p=0.01) and activity at nighttime was lower (p=0.005) at all ages in preterm compared to term infants. Cycled light exposed preterm infants showed the longest nighttime sleep duration. Dim light exposed preterm infants were the least active.
CONCLUSIONS: Preterm infants show an earlier emergence of the 24-h sleep-wake rhythm compared to term infants. Thus, the length of exposure to external time cues such as light may be important for the maturation of infant sleep-wake rhythms. Trial registry number: This trial has been registered at www.clinicaltrials.gov (identifier NCT01513226).

Abstract

BACKGROUND: Previous studies show contradictory results about the emergence of 24-h rhythms and the influence of external time cues on sleep-wake behavior in preterm compared to term infants.
AIMS: To examine whether very preterm infants (<32weeks of gestational age) differ in their emergence of the 24-h sleep-wake rhythm at 5, 11 and 25weeks corrected age compared to term infants and whether cycled light conditions during neonatal intermediate care affects postnatal 24-h sleep-wake rhythms in preterm infants. Study design: Prospective cohort study with nested interventional trial. Subjects: 34 preterm and 14 control term infants were studied. During neonatal hospitalization, preterm infants were randomly assigned to cycled light [7am-7pm lights on, 7pm-7am lights off, n=17] or dim light condition [lights off whenever the child is asleep, n=17]. Outcome measures: Sleep and activity behavior recorded by parental diary and actigraphy at 5, 11 and 25weeks corrected age.
RESULTS: Sleep at nighttime and the longest consolidated sleep period between 12pm-6am was longer (mixed model analysis, factor group: p=0.02, resp. p=0.01) and activity at nighttime was lower (p=0.005) at all ages in preterm compared to term infants. Cycled light exposed preterm infants showed the longest nighttime sleep duration. Dim light exposed preterm infants were the least active.
CONCLUSIONS: Preterm infants show an earlier emergence of the 24-h sleep-wake rhythm compared to term infants. Thus, the length of exposure to external time cues such as light may be important for the maturation of infant sleep-wake rhythms. Trial registry number: This trial has been registered at www.clinicaltrials.gov (identifier NCT01513226).

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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Clinic for Neonatology
04 Faculty of Medicine > University Children's Hospital Zurich > Medical Clinic
04 Faculty of Medicine > Psychiatric University Hospital Zurich > Center for Child and Adolescent Psychiatry
Dewey Decimal Classification:610 Medicine & health
Language:English
Date:27 November 2014
Deposited On:13 Jan 2015 13:23
Last Modified:05 Apr 2016 18:47
Publisher:Elsevier
ISSN:0378-3782
Publisher DOI:https://doi.org/10.1016/j.earlhumdev.2014.11.002
PubMed ID:25460255

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