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Sleep of excessively crying infants: a 24-Hour Ambulatory Sleep Polygraphy study
Jarkko Kirjavainen1, Liisa Lehtonen, Turkka Kirjavainen
1Pediatric Neurology and Clinical Neurophysiology, Turku University Hospital, Turku, Finland. jarkko.kirjavainen@utu.fi
Insights
Excessively crying infants show altered sleep patterns, particularly in rapid eye movement (REM) sleep timing, despite similar total sleep duration. Parental diaries may inaccurately reflect infant sleep duration.
Area of Science:
- Pediatrics
- Sleep Medicine
- Infant Development
Background:
- Parental reports indicate that colicky or excessively crying infants experience reduced sleep compared to healthy infants.
- Understanding the sleep-wake structure is crucial for assessing infant well-being and development.
Purpose of the Study:
- To investigate the 24-hour sleep-wake structure of excessively crying infants.
- To compare the sleep patterns of colicky infants with those of a control group.
Main Methods:
- A 24-hour home sleep polygraphy study was conducted on 24 excessively crying infants and 23 control infants at 6 weeks of age.
- Parental sleep diaries were maintained for 4 days to supplement polygraphy data.
Main Results:
- No significant differences in total sleep duration or overall sleep stage structure were found between the groups via polygraphy.
- Parents in both groups overestimated infant sleep duration, with control group parents showing a greater overestimation.
- Excessively crying infants exhibited a higher proportion of rapid eye movement (REM) sleep in the evening and lower REM sleep in the preceding hours compared to controls.
Conclusions:
- Diary-based sleep studies may be biased due to parental overestimation of infant sleep.
- While total sleep is similar, excessively crying infants may have disruptions in REM and non-REM sleep timing, particularly during evening hours.
Objective:
Parents' reports suggest that excessively crying or colicky infants sleep less compared with control subjects. The aim of this study was to determine the sleep-wake structure of excessively crying infants throughout a 24-hour cycle.
Methods:
A 24-hour sleep polygraphy study was conducted at home for 24 excessively crying infants and 23 control subjects at the age of 6 weeks. In addition, parental diaries were kept for 4 days.
Results:
In sleep polygraphy recordings, no major differences between study groups were observed in either the duration or the structure of the 24-hour sleep. In the diaries, the parents overestimated the amount of sleep in both study groups. The parents of the control infants overestimated the amount of sleep more than the parents of excessively crying infants (69.8 minutes [standard deviation: 79.3] compared with 27.1 minutes [standard deviation: 65.4], respectively). In excessively crying infants, the proportion of rapid eye movement sleep was higher during the 3-hour period from the beginning of the first long sleep in the evening and lower during the preceding 3-hour period compared with the control group.
Conclusions:
The results of this study suggest that diary-based studies are prone to be biased as the parents of the control infants are more likely to overestimate the amount of infant's sleep and, therefore, report more sleep than the parents of the crying infants. Although no differences in the total amount of sleep or proportions of sleep stages were observed, excessively crying infants may be characterized by a disturbance that affects rapid eye movement and non-rapid eye movement sleep stage proportion during evening hours.
