ArticleSleep2021
Sleep-wake regulation in preterm and term infants.
Article in Sleep, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
23 citing papers in PubMed.
- 'I Did Not Know We Could Exercise This Small Premature Baby': Challenges Experienced by Parents While Implementing Early Intervention for Their Preterm Infants-A Qualitative Perspective.Child: care, health and development · 2025Trial
- Physical Activity Profile of School-Aged Children Born Very Preterm and Its Association With Sleep.Acta paediatrica (Oslo, Norway : 1992) · 2026Article
- Metabolic expenditure, neurodevelopment, and weight gain into early childhood after fetal growth restriction.Scientific reports · 2026Article
- The Ontogenetic Development of Rapid Eye Movement Sleep in Early Life and Its Regulatory Mechanisms.International journal of developmental neuroscience : the official journal of the International Society for Developmental Neuroscience · 2026Review
- The impact of sleep in high-risk infants.Pediatric research · 2025Review
- Artificial Intelligence-Based Video Assessment of Neonatal State.JAMA network open · 2025Article
- Co-developing sleep-wake and sensory foundations for cognition in the human fetus and newborn.Developmental cognitive neuroscience · 2025Review
- Docosahexaenoic Acid and Sleep Quality in Very and Extreme Preterm Infants.International journal of environmental research and public health · 2024Article
- Maternal Reports of Preterm and Sick Term Infants' Settling, Sleeping and Feeding in the 9 Months after Discharge from Neonatal Nursery: An Observational Study.Children (Basel, Switzerland) · 2024Article
- Persian version of brief infant sleep questionnaire (BISQ): a psychometric evaluation.BMC pediatrics · 2024Article
- Machine Learning-Derived Active Sleep as an Early Predictor of White Matter Development in Preterm Infants.The Journal of neuroscience : the official journal of the Society for Neuroscience · 2024Article
- Combining Cardiorespiratory Signals and Video-Based Actigraphy for Classifying Preterm Infant Sleep States.Children (Basel, Switzerland) · 2023Article
- Parent Experiences in the NICU and Transition to Home.International journal of environmental research and public health · 2023Article
- Asia-Pacific consensus statement on integrated 24-hour activity guidelines for the early years.The Lancet regional health. Western Pacific · 2023Review
- Sleep state organisation of moderate to late preterm infants in the neonatal unit.Pediatric research · 2023Observational
- Unobtrusive cot side sleep stage classification in preterm infants using ultra-wideband radar.Frontiers in sleep · 2023Article
- Article
- Longitudinal Analysis of Sleep-Wake States in Neonatal Rats Subjected to Hypoxia-Ischemia.Nature and science of sleep · 2022Article
- Precision caffeine therapy for apnea of prematurity and circadian rhythms: New possibilities open up.Frontiers in pharmacology · 2022Review
- Prognostic value of neonatal EEG following therapeutic hypothermia in survivors of hypoxic-ischemic encephalopathy.Clinical neurophysiology : official journal of the International Federation of Clinical Neurophysiology · 2021Article
Corrections and comments
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Authors and funding
6 authors.
Funding
Abstract
STUDY
objectivesIn adults, wakefulness can be markedly prolonged at the expense of sleep, e.g. to stay vigilant in the presence of a stressor. These extra-long wake bouts result in a heavy-tailed distribution (highly right-skewed) of wake but not sleep durations. In infants, the relative importance of wakefulness and sleep are reversed, as sleep is necessary for brain maturation. Here, we tested whether these developmental pressures are associated with the unique regulation of sleep-wake states.
methodsIn 175 infants of 28-40 weeks postmenstrual age (PMA), we monitored sleep-wake states using electroencephalography and behavior. We constructed survival models of sleep-wake bout durations and the effect of PMA and other factors, including stress (salivary cortisol), and examined whether sleep is resilient to nociceptive perturbations (a clinically necessary heel lance).
resultsWake durations followed a heavy-tailed distribution as in adults and lengthened with PMA and stress. However, differently from adults, active sleep durations also had a heavy-tailed distribution, and with PMA, these shortened and became vulnerable to nociception-associated awakenings.
conclusionsSleep bouts are differently regulated in infants, with especially long active sleep durations that could consolidate this state's maturational functions. Curtailment of sleep by stress and nociception may be disadvantageous, especially for preterm infants given the limited value of wakefulness at this age. This could be addressed by environmental interventions in the future.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.