Agreement between behavioural observation and polygraphy for the diagnosis of sleep–wake states in preterm neonates

Sevestre, Anna; Oger, Emmanuel; Bertelle, Valérie; Mabin, D; Sizun, Jacques

doi:10.1111/apa.12185

Cited by 6 publications

(4 citation statements)

References 13 publications

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“…The characteristics of the neonatal unit environment and care provided to premature infants according to the institutional routines can reduce the total sleep time leading them to consequent deprivation, which can be constituted in morbidity factor, especially when the gestational age is low and the length of hospital stay is long (2,4,6) . Many studies show that sleep deprivation of premature infants in the neonatal unit can lead to worsening of clinical status and delay hospital discharge, besides that, it could trigger behavioral disorders in adulthood (4,(7)(8) . PI present sleep with polyphasic pattern that are classified into three stages: active, quiet and indeterminate sleep (3,7,(9)(10) .…”

Section: Introductionmentioning

confidence: 99%

Effect of reducing sensory and environmental stimuli during hospitalized premature infant sleep

Orsi

Llaguno

Avelar

et al. 2015

Rev. esc. enferm. USP

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Objective:To compare the total sleep time of premature infant in the presence or absence of reducing sensory and environmental stimuli in the neonatal unit. Method: Longitudinal study in a Neonatal Intermediate Care Unit of a public hospital in Sao Paulo. The sample consisted of 13 premature infants. We used polysomnograph and unstructured observation for data collection. We analyzed 240 and 1200 minutes corresponding to the periods of the presence and absence of environmental management, respectively. Data were compared in proportion to the total sleep time in the two moments proposed by the study. Results: The total sleep time in periods without environmental management was on average 696.4 (± 112.1) minutes and with management 168.5 (± 27.9) minutes, proportionally premature infant slept an average of 70.2% during periods with no intervention and 58.0% without management (p=0.002). Conclusion: Reducing stimulation and handling of premature infant environment periods was effective to provide greater total sleep time. DESCRIPTORS INTRODUCTIONThe estimate of premature births in Brazil is about 9.8% of the 2,913.160 births registered in 2011 (1) . Due to prematurity, the proportion of premature infants (PI) may require hospitalization in a neonatal unit, which is commonly characterized as in environment that has high sensory stimuli overload for the newborn, additionally, there is a need for frequent management for invasive and painful procedures (2)(3)(4)(5) . The characteristics of the neonatal unit environment and care provided to premature infants according to the institutional routines can reduce the total sleep time leading them to consequent deprivation, which can be constituted in morbidity factor, especially when the gestational age is low and the length of hospital stay is long (2,4,6) . Many studies show that sleep deprivation of premature infants in the neonatal unit can lead to worsening of clinical status and delay hospital discharge, besides that, it could trigger behavioral disorders in adulthood (4,(7)(8) . PI present sleep with polyphasic pattern that are classified into three stages: active, quiet and indeterminate sleep (3,7,(9)(10) . The different stages of sleep are essential for the homeostasis of premature infants, because they establish relations with important physiological and neurological activities (3,9) . In the quiet sleep, decreased basal metabolic rate occurs, which promotes replenishment of energy reserves as well as promote cellular repair, in the active sleep brain activation occurs, which is essential for the structural maturation of the central nervous system (10)(11) . It is noteworthy that the indeterminate sleep cannot be considered as quiet or active, it is characterized as the transition between these two types of sleep patterns (12) . Mitigating possible harmful effects of care provided to hospitalized newborns is one of the actions that should be prioritized by professionals working towards recovery (13) . In this context, the developmental care aims at reduc...

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Section: Introductionmentioning

confidence: 99%

Effect of reducing sensory and environmental stimuli during hospitalized premature infant sleep

Orsi

Llaguno

Avelar

et al. 2015

Rev. esc. enferm. USP

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“…This observational approach is difficult for non-expert in the field with limited data concerning accuracy of the evaluation. Overall agreement among assessors and agreement between behavioral observation and polygraphy appear to be low, at least for untrained staff and especially as the newborn is more premature and registration is shorter ( 55 ). It seems therefore relevant to develop a fully automated method to assess preterm infant stages of sleep.…”

Section: Discussionmentioning

confidence: 99%

Quiet Sleep Organization of Very Preterm Infants Is Correlated With Postnatal Maturation

Cailleau¹,

Weber

Cabon

et al. 2020

Front. Pediatr.

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Background: Sleep is an important determinant of brain development in preterm infants. Its temporal organization varies with gestational age (GA) and post-menstrual age (PMA) but little is known about how sleep develops in very preterm infants. The objective was to study the correlation between the temporal organization of quiet sleep (QS) and maturation in premature infants without severe complications during their neonatal hospitalization. Methods: Percentage of time spent in QS and average duration of time intervals (ADI) spent in QS were analyzed from a cohort of newborns with no severe complications included in the Digi-NewB prospective, multicentric, observational study in 2017–19. Three groups were analyzed according to GA: Group 1 (27–30 weeks), Group 2 (33–37 weeks), Group 3 (>39 weeks). Two 8-h video recordings were acquired in groups 1 and 2: after birth (T1) and before discharge from hospital (T2). The annotation of the QS phases was performed by analyzing video recordings together with heart rate and respiratory traces thanks to a dedicated software tool of visualization and annotation of multimodal long-time recordings, with a double expert reading. Results are expressed as median (interquartile range, IQR). Correlations were analyzed using a linear mixed model. Results: Five newborns were studied in each group (160 h of recording). Median time spent in QS increased from 13.0% [IQR: 13–20] to 28.8% [IQR: 27–30] and from 17.0% [IQR: 15–21] to 29.6% [IQR: 29.5–31.5] in Group 1 and 2, respectively. Median ADI increased from 54 [IQR: 53–54] to 288 s [IQR: 279–428] and from 90 [IQR: 84–96] to 258 s [IQR: 168–312] in Group 1 and 2. Both groups reach values similar to that of group 3, respectively 28.2% [IQR: 24.5–31.3] and 270 s [IQR: 210–402]. The correlation between PMA and time spent in QS or ADI were, respectively 0.73 ( p < 10 −4 ) and 0.46 ( p = 0.06). Multilinear analysis using temporal organization of QS gave an accurate estimate of PMA ( r 2 = 0.87, p < 0.001). Conclusion: The temporal organization of QS is correlated with PMA in newborns without severe complication. An automated standardized continuous behavioral quantification of QS could be interesting to monitor during the hospitalization stay in neonatal units.

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“…Those studies found the use of ear protectors reduced the motor responses of the PTNs and the Anderson Behavioral State Scale indicated an increase in QS and decreases in AS, wakefulness, crying, and changes in sleep patterns (Abdeyazdan, Ghassemi, & Marofi, 2014; Abdeyazdan, Ghassemi, Marofi, & Berjis, 2014; Duran et al, 2012; Zahr & de Traversay, 1995). However, a recent study, which assessed the correlations between the data generated by polysomnography and behavioral observations of preterm infants during sleep and its respective patterns, demonstrated that although there was agreement between examiners using these two methods of sleep evaluation, no unanimity was obtained (Sevestre, Oger, Bertelle, Mabin, & Sizun, 2013).…”

Section: Discussionmentioning

confidence: 99%

Influence of Ear Protectors on the Sleep of Preterm Newborns: A Randomized Controlled Clinical Study

et al. 2018

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The purpose of this study was to compare the effect of ear protectors on the sleep of preterm newborns during the “quiet” times in intermediate care nursery. This was a clinical, randomized, controlled crossover study conducted in two neonatal units in São Paulo, Brazil. The sample consisted of preterm infants who met the inclusion and exclusion criteria for the study. Polysomnography and unstructured observation were used for data collection. Twenty-four preterm infants with a mean gestational age of 33.2 weeks and current weight of 1.747 g were analyzed. There was no significant difference in the total sleep time of preterm infants with and without the use of ear protectors. Newborns with lower gestational age showed a significant reduction in total sleep time with the use of ear protectors ( p < .05). The use of ear protection did not increase the total sleep time for preterm infants.

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Agreement between behavioural observation and polygraphy for the diagnosis of sleep–wake states in preterm neonates

Cited by 6 publications

References 13 publications

Effect of reducing sensory and environmental stimuli during hospitalized premature infant sleep

Effect of reducing sensory and environmental stimuli during hospitalized premature infant sleep

Quiet Sleep Organization of Very Preterm Infants Is Correlated With Postnatal Maturation

Influence of Ear Protectors on the Sleep of Preterm Newborns: A Randomized Controlled Clinical Study

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