Sleep-wake regulation in preterm and term infants.
Sleep-wake regulation in preterm and term infants.
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DOI：
10.1093/sleep/zsaa148
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发表时间：
2021-01-21
期刊：
影响因子：
5.6
通讯作者：
Whitehead K
中科院分区：
文献类型：
--
作者：
Georgoulas A;Jones L;Laudiano-Dray MP;Meek J;Fabrizi L;Whitehead K
在成年人中，觉醒可以以睡眠为代价显着延长，例如在压力源存在的情况下保持警惕。这些超长的唤醒发作导致唤醒持续时间的重尾分布（高度右偏），而不是睡眠持续时间。在婴儿中，觉醒和睡眠的相对重要性是相反的，因为睡眠是大脑成熟所必需的。在这里，我们测试了这些发育压力是否与睡眠-觉醒状态的独特调节有关。在175名经后28-40周（PMA）的婴儿中，我们使用脑电图和行为监测睡眠-觉醒状态。我们构建了睡眠-觉醒回合持续时间和PMA和其他因素（包括应激（唾液皮质醇））的影响的生存模型，并检查了睡眠是否对伤害性扰动（临床上必要的足跟穿刺）有弹性。与成人一样，觉醒时间遵循重尾分布，并随着PMA和压力而延长。然而，与成年人不同的是，主动睡眠时间也有一个重尾分布，而PMA，这些缩短，变得容易受到伤害性感受相关的觉醒。婴儿的睡眠受到不同的调节，特别是长时间的活跃睡眠，可以巩固这种状态的成熟功能。压力和伤害性感受导致的睡眠缩短可能是不利的，特别是对于早产儿，因为在这个年龄段觉醒的价值有限。这可以通过今后的环境干预措施加以解决。
In 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. In 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). Wake 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. Sleep 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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DOI：
10.1523/jneurosci.1809-08.2008
发表时间：
2008-10-01
期刊：
The Journal of neuroscience : the official journal of the Society for Neuroscience
影响因子：
--
作者：
Cano G;Mochizuki T;Saper CB
通讯作者：
Saper CB
影响因子：
5.6
作者：
de Vivo, Luisa;Nagai, Hirotaka;Cirelli, Chiara
通讯作者：
Cirelli, Chiara
影响因子：
7.7
作者：
Dooley, James C.;Blumberg, Mark S.
通讯作者：
Blumberg, Mark S.
影响因子：
2.2
作者：
ANDERS, TF;ROFFWARG, HP
通讯作者：
ROFFWARG, HP
影响因子：
1.9
作者：
Blumberg, MS;Middlemis-Brown, JE;Johnson, ED
通讯作者：
Johnson, ED