Paper
Friday, July 23, 2004
10:00 AM - 10:30 AM
Friday, July 23, 2004
3:00 PM - 3:30 PM
Behavioral and EEG Measurement of Preterm Infant Sleep
Marilyn "Lynn" J. Lotas, RN, PhD, Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, OH, USA and Firas Saker, MD, FAAP, Division of Neonatology, Tod Children's Hospital, Youngstown, OH, USA.
Purpose: Sleep is a major influence on the preterm infant’s neurological development, growth, and ability to withstand the stress of premature extra-uterine life. Infants in the NICU get inadequate sleep due to excessive NICU light and the demands of caregiving. Nurses have addressed this through “clustered care” protocols to provide scheduled rest periods and by light reduction strategies including covering incubators with a variety of blankets or hoods. This pilot study tests 1) the effect of scheduled three-four hour inter-feeding rest periods (IFRP) and light reduction on the development of infant sleep architecture as measured by electroencephalogram and behavioral state; 2) changes in sleep patterns over time. Conceptual Framework: Three related propositions form the conceptual basis for this study. First, structured light/dark cycles are a primary organizer of biological rhythms in sleep architecture. Second, in infants, feeding cycles are a major organizer of biological rhythms and have been shown to enhance the effects of light cycles on sleep development. Third, distinct sleep/wake cycling develops in preterm infants as early as 28 weeks gestational age. Sample: The sample is a non-probability sample consisting of 10 infants at 28-30 weeks post-conceptional age. Method: This is a pretest-test-posttest pilot study. Subjects are randomly assigned to one of two study groups: (Control) infants are maintained in routine care which does not include regular scheduled rest periods. The incubator is covered with a light receiving blanket at the nurses discretion; (Experimental) daily scheduled IRFP’s in a covered incubator. Sleep is measured during two IFRP’s on Study Days 1,7, 14 and 21 by EEG and behaviorally by the Thoman State Scale. EEGs are scored for the number of epochs of quiet sleep, active sleep, awake time, total amount of sleep, and percent of time spent in sleep and waking states. Results/Conclusions: Data analysis is in progress.
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Sigma Theta Tau International
July 22-24, 2004