Analysis of factors associated with development of sleep-wake rhythm in early infancy indicated by melatonin secretion

这项研究的目的是通过纵向和客观的睡眠评估，更准确地了解婴儿早期睡眠发育、哭闹和唾液褪黑素之间的关系。研究设计是对出生后前4个月的婴儿进行前瞻性纵向研究。这项研究包括31名健康的足月儿。每隔大约4-6周，当婴儿4-6周、8-10周和14-16周时，他们的母亲被要求按时间表记录婴儿的哭闹/挑剔行为，并在3天内为婴儿附加活动记录仪。14~16周时，每日测定唾液褪黑素(每天4次)。从横断面(年龄组)和纵向(个体)两个角度研究了放射学睡眠参数与每24小时哭闹/烦躁行为持续时间的关系。唾液褪黑素浓度与S…照相的关系在14-16周时评估更多的LEEP参数或哭闹/烦躁的持续时间。当从横断面的角度分析这些关系时，只有一个睡眠参数在14-16周龄的一个测量点上发现了微弱但显著的相关性，即总睡眠中活跃睡眠的百分比(r=0.44，p=0.02)。然而，当从纵向角度分析数据时，哭闹/挑剔行为的持续时间与总睡眠的活跃睡眠百分比(r=0.36，p=0.006)、每24小时的睡眠次数(r=0.36，p=0.007)以及夜间睡眠百分比(p=-0.31)之间存在显著的关系。这些结果表明，婴幼儿早期哭声的消退与睡眠发育是平行的现象。此外，结果表明，在3个月大的婴儿中，活跃睡眠百分比的增加可能是他们仍然经常哭泣的特征。14-16周婴儿的每日唾液褪黑素浓度与放射学睡眠参数或哭闹/烦躁的持续时间无关。较少

The Objective of this study was to understand the relationships among sleep developments, crying episodes and salivary melatonin during early infancy more accurately by longitudinal and objective sleep evaluations. Study design was a prospective longitudinal study of infants in the first 4 months of postnatal life. The study included 31 healthy term infants. At approximately 4-6 week intervals, when the infants were age 4-6 weeks, 8-10 weeks, and 14-16 weeks, their mothers were asked to record the crying/fussy behavior of her infant in a timetable and to attach an actigraph to their infant for 3 days. At 14-16weeks, measurements of daily salivary melatonin (4 times per day) were additionally performed. The relationship between the actinographic sleep parameters and duration of crying/fussy behavior per 24 hours was examined from both cross-sectional (age group) and longitudinal (individual) perspectives. The relationship between salivary melatonin concentrations and the actinographic s … More leep parameters or duration of crying/fussy were also evaluated at 14-16 weeks. When the relationships were examined from a cross-sectional perspective, a weak but significant correlation was found in only one sleep parameter, percent of active sleep per total sleep, at only one measuring point, at 14-16 weeks of age (r=0.44, p=0.02). However, when the data were examined from a longitudinal perspective, there were significant relationships between the duration of crying/fussy behavior and percent of active sleep per total sleep (r=0.36, p=0.006), episodes of sleep per 24 hr (r=0.36, p=0.007), and percent of sleep during night (p=0.02, r=-0.31). These results suggested that subsiding of early crying and sleep development reflected by these sleep parameters in infants are parallel phenomenon. Furthermore, the results suggested that an increased percentage of active sleep may be characteristic among infants who still cry frequently at the age of 3 months. Daily salivary melatonin concentrations of infants at 14-16 weeks were not associated with actinographic sleep parameters or duration of crying/fussy. Less