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Updated: Mar 20, 2026

Preterm EEG: A Multimodal Neurophysiological Protocol
Published on: February 18, 2012
Effect of sleeping position on arousals from sleep in preterm infants
Ingrid Felix Modesto1, Ariane Ferreira Machado Avelar2, Mavilde da Luz Gonçalves Pedreira3
1Scientific initiation scholarship FAPESP, Escola Paulista de Enfermagem-Universidade Federal de São Paulo, São Paulo, Brazil.
Insights
Preterm infants experience more sleep arousals in the supine position. Nurses should consider alternative positions to improve sleep quality in premature infants.
Area of Science:
- Neonatal care
- Infant sleep studies
- Developmental pediatrics
Background:
- Preterm infants often experience sleep disturbances.
- Understanding sleep positions is crucial for optimizing infant development and well-being.
Purpose of the Study:
- To determine the frequency of sleep positions in preterm infants.
- To investigate associations between sleep positions, arousals, sleep patterns, and time of day.
Main Methods:
- Observational study in a neonatal unit.
- Utilized polysomnographic and video recordings over 24 hours.
- Monitored 10 preterm infants for sleep positions and arousals.
Main Results:
- Supine position was most frequent (58.4%), followed by right side, left side, and prone.
- The supine position showed the highest number of arousals per hour.
- No significant differences in arousals were found based on sleep pattern or time of day.
Conclusions:
- The supine position is associated with more frequent arousals in preterm infants.
- Healthcare providers should consider sleep position's impact on arousal frequency.
- Optimizing sleep positions may enhance sleep quality in preterm infants.
Purpose:
To evaluate the frequency of preterm infant positions during sleep, and to investigate the association among positions, arousals, sleep patterns, and time of day.
Design And Methods:
This observational study was conducted in a neonatal unit with 10 preterm infants. Polysomnographic and video recordings during 24 hr identified sleep positions, arousals, sleep patterns, and time of day.
Results:
Preterm infants were placed most frequently in the supine position (58.4%), followed by right side (24.9%), left side (15.5%), and prone (1.2%). The longest amount of time spent sleeping, and the most frequent number of arousals, occurred in the supine position, followed by prone, left-side, and right-side positions. After controlling for length of time spent in each position, the number of arousals per hour was the greatest in the supine position (13.562 ± 0.732) and least in the prone position (11.56 ± 4.754; p < .001). There were no significant differences in arousals according to position and sleep pattern (indeterminate, quiet, active sleep) or position and time of day (morning, afternoon, twilight, night).
Practice Implications:
Nurses should evaluate the frequency of preterm infant arousals in each position, and use more often those positions that lead to a lower frequency of arousals and better sleep quality.
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