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Sleep architecture and continuity measures of neonates with chronic lung disease
M S Scher1, G A Richardson, D G Salerno
1Department of Pediatrics, Magee-Womens Hospital, Pittsburgh, Pennsylvania 15213.
Insights
Infants with chronic lung disease (CLD) show altered sleep patterns, including less active sleep and more indeterminate sleep. These changes in electroencephalographic (EEG) sleep architecture may indicate impaired brain development and predict future neurodevelopmental outcomes.
Area of Science:
- Neonatal Neuroscience
- Sleep Medicine
- Pediatric Pulmonology
Background:
- Chronic lung disease (CLD) is a common complication in preterm infants.
- Preterm infants are at risk for neurodevelopmental challenges.
- Sleep disturbances can reflect underlying neurological and physiological issues in neonates.
Purpose of the Study:
- To investigate the impact of chronic lung disease (CLD) on the electroencephalographic (EEG) sleep architecture of preterm neonates.
- To compare sleep patterns in neonates with CLD to healthy preterm and fullterm controls.
- To explore the potential of EEG sleep measures as predictors of neurodevelopmental outcomes in infants with CLD.
Main Methods:
- 21-channel electroencephalographic (EEG) recordings were obtained from 25 preterm neonates with CLD (corrected to fullterm postconceptional age).
- Sleep studies were compared to two control groups: fullterm appropriate for gestational age neonates and preterm neonates without CLD (corrected to term).
- Minute-by-minute visual analyses assessed sleep state, arousals, body movements, and rapid eye movements (REM).
Main Results:
- Neonates with CLD exhibited a significant reduction in active sleep percentage (31.15%) compared to both control groups (47.01% and 52.9%).
- The CLD group showed a significantly increased percentage of indeterminate sleep (31.23%) compared to controls (15.18% and 11.5%).
- Infants with CLD had more frequent and longer arousals, and a higher number of body movements per minute than healthy preterm controls.
Conclusions:
- Chronic lung disease adversely affects the neurophysiological organization of the immature brain, as evidenced by altered neonatal sleep architecture.
- Abnormalities in EEG sleep patterns and continuity in neonates with CLD suggest potential neurodevelopmental impacts.
- EEG sleep measures may serve as valuable tools for predicting the longitudinal neurodevelopmental outcomes in infants diagnosed with CLD.
Abstract:
Electroencephalographic (EEG) sleep studies of 25 preterm neonates with chronic lung disease (CLD) corrected to a fullterm postconceptional age were compared with recordings from two groups of neonates without CLD: a fullterm appropriate for gestational age group (9 patients) and a preterm group studied at a corrected term postconceptional age (15 patients). Electrographic/polygraphic studies were obtained using 21-channel EEG recordings. Scores were tabulated based on minute-by-minute visual analyses of sleep state, number and duration of arousals, body movements and rapid eye movements (REM). A significant reduction in the percentage of active sleep was noted in the CLD group compared to both control groups (31.15% vs. 47.01% and 52.9%, respectively). The mean percentage of indeterminate sleep was significantly increased in the study group as compared to both control groups (31.23% vs. 15.18% and 11.5%). In addition, significant differences were noted between the CLD group and the healthy preterm control group with respect to the number (0.29/minute vs. 0.13/minute) and duration (4.8 seconds vs. 2.94 seconds) of arousals as well as the total number of body movements (1.57/minute vs. 0.74/minute). These data suggest that neurophysiological organization of the immature brain, as reflected in neonatal sleep architecture and continuity measures, is adversely affected in neonates with CLD. EEG sleep architecture and continuity measures may be helpful in predicting the longitudinal outcome of infants with CLD as this group is at risk for adverse neurodevelopmental outcome.