The sleep protection in the preterm infants

Abstract

The importance of sleep in the development is only now beginning to be understood: sleep and established sleep cycles have an important role in the normal neurosensory and cortex development. The biological basis of sleep organization has been highlighted by several studies however environmental differences can affect the sleep patterns in preterm infants in the NICU. Sleep disorders are related to several physiological conditions but it is important to know the relationship between sleep organization and neurocognitive and socio-emotional outcomes. From the recent literature it is possible to find out potentially better practices that preserve and promote infant sleep in the NICU.

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

“…Although nap time proposed by the NICU have been effective in promoting sleep of those premature infants investigated, the results allow concluding that in the remaining 20 hours there was no environmental management, total sleep time was only 11.6 hours. Proportionally, this finding shows that the total sleep time of newborns was lower than recommended by the literature, which highlights they require 17-22 hours of sleep, depending on gestational age (18)(19) . The data from observations allowed us to infer that the total sleep time was lower in the absence of environment management due to handling of newborns by unit staff and cry arising from care, which may have boosted the increase in the noise level and the consequent environmental acoustics change in general.…”

“…The data from observations allowed us to infer that the total sleep time was lower in the absence of environment management due to handling of newborns by unit staff and cry arising from care, which may have boosted the increase in the noise level and the consequent environmental acoustics change in general. This result also indicates that premature infants are being deprived of sleep, which can cause various deleterious effects such as stress, irritability, increased heart rate, basal metabolism with consequent weight loss, increased susceptibility to infections and changes in pain perception (14,18,20) . Sleep deprivation may be related to the impairment of sick children, generating an increase in hospitalization costs and delaying hospital discharge (20) .…”

O efeito da manipulação sobre o sono do recém-nascido prematuro

“…(1)(2)(3)(4) In modern neonatal intensive care units (NICU), preterm infants are generally subjected to multiple sensory and physical stimuli associated with excessive handling by health teams.…”

“…(12) Studies have found that excessive handling and sleep deprivation in preterm infants may impair neuromotor development, induce hyperexcitability, trigger or exacerbate psychiatric diseases, and cause excessive daytime sleepiness. (1,(13)(14)(15) Furthermore, sleep is the main behavioral state of preterm infants and constitutes an important basic need. It is conducive to maturation of the central nervous system, memory consolidation, learning, energy maintenance, thermoregulation, promotion of protein synthesis, and the production of certain hormones, such as growth, thyroid stimulation, melatonin, prolactin, renin, and cortisol.…”

“…The need for sleep of preterm infants varies according to their development stage and individual physiological characteristics. (1,(18)(19) Sleep during the neonatal period is divided into three stages: Active sleep (AS) or REM, in which the newborn manifests rapid eye movement, high physiological activity, and irregular heartbeats and breathing, with a strong correlation with brain growth. (20) The other stage is called quiet sleep (QS) or NREM (non-rapid eye movement), which is characterized by slower waves when recorded in electroencephalograms (EEG).…”