Sleep in the Neonatal Intensive Care Unit

Neonatal Intensive Care Unit, Department of Paediatrics, University Hospital, Sherbrooke, Québec, Canada.
The Journal of perinatal & neonatal nursing (Impact Factor: 1.1). 04/2007; 21(2):140-8; quiz 149-50. DOI: 10.1097/01.JPN.0000270631.96864.d3
Source: PubMed


Recent experimental data suggest a strong role for sleep in brain development. As sleep is the predominant behavioral state in the term and especially the preterm newborn, these data underline the importance of respecting sleep duration and organization within the different sleep states. Polysomnography is the preferred technique used for identification of sleep state; however, behavioral observations-under the condition that the observer is well trained-may prove as efficient. Newborns hospitalized in the neonatal intensive care unit are exposed to many stimuli and care activities that disrupt their sleep organization and may have irreversible effects on their brain development. In order to improve the long-term neurobehavioral outcome of these high-risk subjects, a consistent care approach is proposed. Application of the Neonatal Individualized Developmental Care and Assessment Program decreases environmental stressful events and promotes harmonious well-being behaviors, based on an individual approach. This strategy has encouraging results, showing an increase in sleep duration under Neonatal Individualized Developmental Care and Assessment Program conditions, but further studies are needed to assess its long-term neurobehavioral impact.

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    • "Sleep is considered a crucial action of neonatal period similar to breathing and nutrition. Improvement of the physical growth of neonates depends on sleep (Bertelle et al., 2007). Today, the rate of neonates referred to the NICU and demand intense cares due to prematurity or physical problems is increasing. "
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    ABSTRACT: Fetus and neonate spend most of their time sleeping inside and outside the womb. Sleep is considered a crucial action of neonatal period similar to breathing and nutrition. It plays a key role in brain development. Today, it is shown that sleep plays a predominant role in body temperature regulation, energy saving and neuronal detoxification. Sleep is the most important behavioral state of neonates, particularly in preterm ones. Noise, light, invasive treatment and caring activities are among disturbing factors in the neonatal intensive care unit (NICU) that leave negative impacts on brain development through disturbing the sleep process. MATERIALS & METHODS: This descriptive study assessed all NICU nurses of Ali-ibn-Abitaleb hospital using the census sampling method. Demographic data was collected through a questionnaire with 10 questions about active sleep (AS) cycles, also referred to as REM, methods for inducing AS and AS specifications in neonates. The questionnaire was distributed between the nurses. After completion, data was analyzed using SPSS 16 and descriptive statistics method. FINDINGS: According to analyses, 24%, 20%, 48% and 92% of nurses gave correct answers to questions about AS cycle, AS in neonates, the role of sleep in saving energy and ideal noise level, respectively.CONCLUSION: According to results, nurses had a low level of knowledge towards neonatal sleep. All nurses need to know the importance of sleep in preterm neonates. The main role of inducing sleep is to protect the development of the neonates’ brain in the NICU. Those nurses who spend a remarkable portion of their time for caring neonates in the NICU play a significant role in neonatal sleep care.
    Full-text · Article · Nov 2015 · Global journal of health science
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    • "The most immature neonates will spend as long as three to four months in the neonatal intensive care unit and are subjected to environmental effects for a longer period of time. Developmentally sensitive carepaths for nurses and physicians have been developed to improve ongoing care for neonates as assessed by sleep, growth and age at discharge (Bertelle et al 2005) (Bertelle et al. 2007). "
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    ABSTRACT: Skin-to-skin contact (SSC) promotes physiological stability and interaction between parents and infants. Analyses of EEG-sleep studies can compare functional brain maturation between SSC and non-SSC cohorts. Sixteen EEG-sleep studies were performed on eight preterm infants who received 8 weeks of SSC, and compared with two non-SSC cohorts at term (N=126), a preterm group corrected to term age and a full-term group. Seven linear and two complexity measures were compared (Mann-Whitney U test comparisons p<.05). Fewer REMs, more quiet sleep, increased respiratory regularity, longer cycles, and less spectral beta were noted for SSC preterm infants compared with both control cohorts. Fewer REMs, greater arousals and more quiet sleep were noted for SSC infants compared with the non-SSC preterms at term. Three right hemispheric regions had greater complexity in the SSC group. Discriminant analysis showed that the SSC cohort was closer to the non-SSC full-term cohort. Skin-to-skin contact accelerates brain maturation in healthy preterm infants compared with two groups without SSC. Combined use of linear and complexity analysis strategies offer complementary information regarding altered neuronal functions after developmental care interventions. Such analyses may be helpful to assess other neuroprotection strategies.
    Full-text · Article · Sep 2009 · Clinical neurophysiology: official journal of the International Federation of Clinical Neurophysiology
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    ABSTRACT: The purpose of this study was to examine prevalence rates of symptoms of several sleep disorders in young children, and the relationship between symptoms of pediatric sleep disorders and other childhood problems. Two-hundred-seventy-six children aged 2 to 5 years were studied through examination of a pre-existing database. Children rated as high risk for having a sleep disorder displayed significantly more aggressive behavior and attention problems, as compared to children whose sleep was rated in the normal range. However, no relationship was found between symptoms of sleep disorders and body mass index, asthma, or allergies. In addition, no relationship was found between symptoms of sleep disorders and social skills. Twenty-six percent of children in this sample were at high risk for having at least one type of sleep disorder. Results are discussed with regard to implications for prevention and early identification of students who are at-risk for developing sleep disorders, as well as direct interventions for those students who have a diagnosed sleep disorder.
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