Sleep Medicine and Psychophysiology (수면정신생리)

KOREAN ACADEMY OF SLEEP MEDICINE (대한수면의학회)
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Sleep Characteristics in Infants

영아의 수면 특성

  • Rhie, Seonkyeong (Departments of Pediatrics, CHA Bundang Medical Center, CHA University School of Medicine)
  • 이선경 (차의과학대학교 분당차병원 소아청소년과)
  • Received : 2020.12.02
  • Accepted : 2020.12.27
  • Published : 2020.12.31
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Abstract

An infant's sleep varies considerably from that of adults in terms of structure, amount, and breathing pattern. After birth, sleep becomes evenly distributed throughout the day and night. Nighttime sleep gradually increases with the maturation of circadian rhythm, and sleep is gradually consolidated. Electroencephalography characteristics change with age, from early and dominant active (REM) sleep in newborns to increasing NREM sleep. Similar to other elements of growth, the upper respiratory tract and ribcage gradually increase in size with age, and respiratory control also improves. With these changes, sleep patterns also change. At this time that various sleep disorders may appear. Improved understanding of age-dependent changes in infant sleep can help determine the etiology and facilitate diagnosis of infant sleep diseases.

Keywords

References

  1. 고영율, 김규언, 김진택, 김창휘, 김현희, 박준수 등. 호흡기질환. 안효섭. 홍창의 소아과학(12판): 미래엔;2020. p.680-789.
  2. 김기수, 김병일, 김애란, 김행미, 남궁란, 박문성 등. 신생아질환. 안효섭. 홍창의 소아과학(12판): 미래엔;2020. p.246-371.
  3. 성인경. 성장과 발달. 안효섭. 홍창의 소아과학(12판): 미래엔;2020. p.10-37.
  4. 최중환. 서론. 안효섭. 홍창의 소아과학(12판): 미래엔;2020. p.2-9.
  5. Anagnostopoulou P, Latzin P, Jensen R, Stahl M, Harper A, Yammine S, et al. Normative data for multiple breath washout outcomes in school-aged caucasian children. Eur Respir J 2020;55:1901302. https://doi.org/10.1183/13993003.01302-2019
  6. Anders TF, Halpern LF, Hua J. Sleeping through the night: A developmental perspective. Pediatrics 1992;90:554-560.
  7. Ardura J, Andres J, Aldana J, Revilla MA. Development of sleep-wakefulness rhythm in premature babies. Acta Paediatr 1995; 84:484-489. https://doi.org/10.1111/j.1651-2227.1995.tb13679.x
  8. Ardura J, Gutierrez R, Andres J, Agapito T. Emergence and evolution of the circadian rhythm of melatonin in children. Horm Res 2003;59:66-72. https://doi.org/10.1159/000068571
  9. Arens R, Marcus CL. Pathophysiology of upper airway obstruction: A developmental perspective. Sleep 2004;27:997-1019. https://doi.org/10.1093/sleep/27.5.997
  10. Avidan AY, Barkoukis TJ. Review of Sleep Medicine E-book: Elsevier Health Sciences;2011.
  11. Banks S, Dinges DF. Behavioral and physiological consequences of sleep restriction. J Clin Sleep Med 2007;3:519-528. https://doi.org/10.5664/jcsm.26918
  12. Berry R, Brooks R, Gamaldo C. The AASM Manual for the Scoring of Sleep and Associated Events: Rules, Terminology and Technical Specifications, version 2.6. 0. American academy of sleep medicine, darien, illinois;2020.
  13. Bruni O, Baumgartner E, Sette S, Ancona M, Caso G, Di Cosimo ME, et al. Longitudinal study of sleep behavior in normal infants during the first year of life. J Clin Sleep Med 2014;10:1119-1127. https://doi.org/10.5664/jcsm.4114
  14. Contencin P, Gumpert L, Sleiman J, Possel L, De Gaudemar I, Adamsbaum C. Nasal fossae dimensions in the neonate and young infant: A computed tomographic scan study. Arch Otolaryngol Head Neck Surg 1999;125:777-781. https://doi.org/10.1001/archotol.125.7.777
  15. de Weerth C, Zijl RH, Buitelaar JK. Development of cortisol circadian rhythm in infancy. Early Hum Dev 2003;73:39-52. https://doi.org/10.1016/S0378-3782(03)00074-4
  16. Engle WA, American Academy of Pediatrics Committee on F, Newborn. Age terminology during the perinatal period. Pediatrics 2004;114:1362-1364. https://doi.org/10.1542/peds.2004-1915
  17. Ficca G, Fagioli I, Salzarulo P. Sleep organization in the first year of life: Developmental trends in the quiet sleep-paradoxical sleep cycle. J Sleep Res 2000;9:1-4.
  18. Fleming S, Thompson M, Stevens R, Heneghan C, Pluddemann A, Maconochie I, et al. Normal ranges of heart rate and respiratory rate in children from birth to 18 years of age: A systematic review of observational studies. Lancet 2011;377:1011-1018. https://doi.org/10.1016/S0140-6736(10)62226-X
  19. Fuchs O, Latzin P, Thamrin C, Stern G, Frischknecht P, Singer F, et al. Normative data for lung function and exhaled nitric oxide in unsedated healthy infants. Eur Respir J 2011;37:1208-1216. https://doi.org/10.1183/09031936.00125510
  20. Goldwater PN. A perspective on sids pathogenesis. The hypotheses: Plausibility and evidence. BMC Med 2011;9:64. https://doi.org/10.1186/1741-7015-9-64
  21. Goto K, Mirmiran M, Adams MM, Longford RV, Baldwin RB, Boeddiker MA, et al. More awakenings and heart rate variability during supine sleep in preterm infants. Pediatrics 1999;103: 603-609. https://doi.org/10.1542/peds.103.3.603
  22. Grigg-Damberger MM. The visual scoring of sleep in infants 0 to 2 months of age. J Clin Sleep Med 2016;12:429-445. https://doi.org/10.5664/jcsm.5600
  23. Hellbruegge T. The development of circadian rhythms in infants. Cold Spring Harb Symp Quant Biol 1960;25:311-323. https://doi.org/10.1101/SQB.1960.025.01.032
  24. Henderson-Smart DJ, Read DJ. Reduced lung volume during behavioral active sleep in the newborn. J Appl Physiol Respir Environ Exerc Physiol 1979;46:1081-1085.
  25. Henderson JM, France KG, Blampied NM. The consolidation of infants' nocturnal sleep across the first year of life. Sleep Med Rev 2011;15:211-220. https://doi.org/10.1016/j.smrv.2010.08.003
  26. Henderson JM, France KG, Owens JL, Blampied NM. Sleeping through the night: The consolidation of self-regulated sleep across the first year of life. Pediatrics 2010;126:e1081-1087.
  27. Hjern A, Lindblom K, Reuter A, Silfverdal SA. A systematic review of prevention and treatment of infantile colic. Acta Paediatr 2020; 109:1733-1744. https://doi.org/10.1111/apa.15247
  28. Iglowstein I, Jenni OG, Molinari L, Largo RH. Sleep duration from infancy to adolescence: Reference values and generational trends. Pediatrics 2003;111:302-307. https://doi.org/10.1542/peds.111.2.302
  29. Isler JR, Thai T, Myers MM, Fifer WP. An automated method for coding sleep states in human infants based on respiratory rate variability. Dev Psychobiol 2016;58:1108-1115. https://doi.org/10.1002/dev.21482
  30. Iwata O, Okamura H, Saitsu H, Saikusa M, Kanda H, Eshima N, et al. Diurnal cortisol changes in newborn infants suggesting entrainment of peripheral circadian clock in utero and at birth. J Clin Endocrinol Metab 2013;98:E25-32.
  31. Iwata S, Fujita F, Kinoshita M, Unno M, Horinouchi T, Morokuma S, et al. Dependence of nighttime sleep duration in one-month-old infants on alterations in natural and artificial photoperiod. Sci Rep 2017;7:44749. https://doi.org/10.1038/srep44749
  32. Knill R, Andrews W, Bryan AC, Bryan MH. Respiratory load compensation in infants. J Appl Physiol 1976;40:357-361. https://doi.org/10.1152/jappl.1976.40.3.357
  33. Libenson MH. The electroencephalogram of the newborn. In: Libenson MH. Practical Approach to Electroencephalography: Elsevier Health Sciences;2012.
  34. Likus W, Bajor G, Gruszczynska K, Baron J, Markowski J. Nasal region dimensions in children: act study and clinical implications. Biomed Res Int 2014;2014:125810. https://doi.org/10.1155/2014/125810
  35. Lohr B, Siegmund R. Ultradian and circadian rhythms of sleep-wake and food-intake behavior during early infancy. Chronobiol Int 1999;16:129-148. https://doi.org/10.3109/07420529909019081
  36. Lopp S, Navidi W, Achermann P, LeBourgeois M, Diniz Behn C. Developmental changes in ultradian sleep cycles across early childhood. J Biol Rhythms 2017;32:64-74. https://doi.org/10.1177/0748730416685451
  37. Louis J, Cannard C, Bastuji H, Challamel MJ. Sleep ontogenesis revisited: a longitudinal 24-hour home polygraphic study on 15 normal infants during the first two years of life. Sleep 1997;20: 323-333. https://doi.org/10.1093/sleep/20.5.323
  38. Luijk MP, Kocevska D, Tham EK, Gaudreau H, Reiss IK, Duijts L, et al. Gestational age at birth and sleep duration in early childhood in three population-based cohorts. Sleep Medicine: X 2019;1:100002. https://doi.org/10.1016/j.sleepx.2019.100002
  39. Lunshof S, Boer K, Wolf H, van Hoffen G, Bayram N, Mirmiran M. Fetal and maternal diurnal rhythms during the third trimester of normal pregnancy: outcomes of computerized analysis of continuous twenty-four-hour fetal heart rate recordings. Am J Obstet Gynecol 1998;178:247-254. https://doi.org/10.1016/S0002-9378(98)80008-2
  40. Marcus CL, Fernandes Do Prado LB, Lutz J, Katz ES, Black CA, Galster P, et al. Developmental changes in upper airway dynamics. J Appl Physiol (1985) 2004;97:98-108. https://doi.org/10.1152/japplphysiol.00462.2003
  41. McMillen IC, Kok JS, Adamson TM, Deayton JM, Nowak R. Development of circadian sleep-wake rhythms in preterm and fullterm infants. Pediatr Res 1991;29:381-384. https://doi.org/10.1203/00006450-199104000-00010
  42. Merica H, Gaillard JM. Internal structure of sleep cycles in a healthy population. Sleep 1986;9:502-513. https://doi.org/10.1093/sleep/9.4.502
  43. Milerad J, Hertzberg T, Wennergren G, Lagercrantz H. Respiratory and arousal responses to hypoxia in apnoeic infants reinvestigated. Eur J Pediatr 1989;148:565-570. https://doi.org/10.1007/BF00441560
  44. Miller HC, Behrle FC. The effects of hypoxia on the respiration of newborn infants. Pediatrics 1954;14:93-103.
  45. Mindell JA, Moore M. Bedtime problems and night wakings. In: Kryger MH, Roth T, Dement WC. Principles and Practice of Pediatric Sleep Medicine, 2nd edit: Elsevier;2016. p.105-109.
  46. Mirmiran M, Baldwin RB, Ariagno RL. Circadian and sleep development in preterm infants occurs independently from the influences of environmental lighting. Pediatr Res 2003;53:933-938. https://doi.org/10.1203/01.PDR.0000061541.94620.12
  47. Nishihara K, Horiuchi S, Eto H, Uchida S. The development of infants' circadian rest-activity rhythm and mothers' rhythm. Physiol Behav 2002;77:91-98. https://doi.org/10.1016/S0031-9384(02)00846-6
  48. Onigbanjo MT, Feigelman S. First year. In: Kliegman RM, Geme JS. Nelson textbook of pediatrics: Elsevier Health Sciences; 2019. p.131-137.e131.
  49. Peirano P, Algarin C, Uauy R. Sleep-wake states and their regulatory mechanisms throughout early human development. J Pediatr 2003;143:S70-79.
  50. Pillay K, Dereymaeker A, Jansen K, Naulaers G, Van Huffel S, De Vos M. Automated eeg sleep staging in the term-age baby using a generative modelling approach. J Neural Eng 2018;15: 036004. https://doi.org/10.1088/1741-2552/15/3/036004
  51. Rivkees SA. Developing circadian rhythmicity in infants. Pediatrics 2003;112:373-381. https://doi.org/10.1542/peds.112.2.373
  52. Sarnaik AP, Heidemann SM, Clark JA. Respiratory pathophysiology and regulation. In: Kliegman RM, Stanton BF, Geme JS, Schor NF. Nelson Textbook of Pediatrics: Elsevier Health Sciences; 2015.
  53. Scher MS. Pediatric neurophysiologic evaluation. In: Swaiman KF, Ashwal S, Ferriero DM, Schor NF, Finkel RS, Gropman AL, Pearl PL, Shevell M. Swaiman's Pediatric Neurology E-book: Principles and practice: Elsevier Health Sciences;2017. p.212-265.
  54. Scher MS, Johnson MW, Holditch-Davis D. Cyclicity of neonatal sleep behaviors at 25 to 30 weeks' postconceptional age. Pediatr Res 2005;57:879-882. https://doi.org/10.1203/01.PDR.0000157678.84132.A8
  55. Scholle S, Wiater A, Scholle HC. Normative values of polysomnographic parameters in childhood and adolescence: cardiorespiratory parameters. Sleep Med 2011;12:988-996. https://doi.org/10.1016/j.sleep.2011.05.006
  56. Seron-Ferre M, Riffo R, Valenzuela GJ, Germain AM. Twenty-fourhour pattern of cortisol in the human fetus at term. Am J Obstet Gynecol 2001;184:1278-1283. https://doi.org/10.1067/mob.2001.113322
  57. Simons SS, Beijers R, Cillessen AH, de Weerth C. Development of the cortisol circadian rhythm in the light of stress early in life. Psychoneuroendocrinology 2015;62:292-300. https://doi.org/10.1016/j.psyneuen.2015.08.024
  58. Sovik S, Lossius K. Development of ventilatory response to transient hypercapnia and hypercapnic hypoxia in term infants. Pediatr Res 2004;55:302-309. https://doi.org/10.1203/01.PDR.0000106316.40213.DB
  59. Stern E, Parmelee AH, Akiyama Y, Schultz MA, Wenner WH. Sleep cycle characteristics in infants. Pediatrics 1969;43:65-70.
  60. Tal A. Obstructive sleep apnea syndrome: Pathyphysiology and clinical characteristics. In: Kryger MH, Roth T, Dement WC. Principles and Practice of Pediatric Sleep Medicine, 2nd edit: Elsevier;2016. p.215-220.
  61. Tham EK, Schneider N, Broekman BF. Infant sleep and its relation with cognition and growth: a narrative review. Nat Sci Sleep 2017; 9:135-149. https://doi.org/10.2147/NSS.S125992
  62. Thomas KA, Burr RL, Spieker S. Light and maternal influence in the entrainment of activity circadian rhythm in infants 4-12 weeks of age. Sleep Biol Rhythms 2016;14:249-255. https://doi.org/10.1007/s41105-015-0046-2
  63. Troxler RB, Harding SM. Principles and practice of pediatric sleep medicine, 2nd edit. In: Kryger MH, Roth T, Dement WC. Principles and Practice of Sleep Medicine: Elsevier;2016. p.82-90.
  64. Troxler RB, Harding SM. Respiratory physiology and pathophysiology during sleep. In: Carroll JL, Donnelly DF. Principles and Practice of Pediatric Sleep Medicine, 2nd edit: Elsevier;2016. p.179-194.
  65. Tsai SY, Barnard KE, Lentz MJ, Thomas KA. Mother-infant activity synchrony as a correlate of the emergence of circadian rhythm. Biol Res Nurs 2011;13:80-88. https://doi.org/10.1177/1099800410378889
  66. Tsai SY, Thomas KA, Lentz MJ, Barnard KE. Light is beneficial for infant circadian entrainment: an actigraphic study. J Adv Nurs 2012;68:1738-1747. https://doi.org/10.1111/j.1365-2648.2011.05857.x
  67. van der Hal AL, Rodriguez AM, Sargent CW, Platzker AC, Keens TG. Hypoxic and hypercapneic arousal responses and prediction of subsequent apnea in apnea of infancy. Pediatrics 1985;75: 848-854.
  68. Wani TM, Bissonnette B, Rafiq Malik M, Hayes D Jr, Ramesh AS, Al Sohaibani M, et al. Age-based analysis of pediatric upper airway dimensions using computed tomography imaging. Pediatr Pulmonol 2016;51:267-271. https://doi.org/10.1002/ppul.23232
  69. Wani TM, Simion C, Rehman S, John J, Guruswamy V, Bissonnette B, et al. Mainstem bronchial diameters and dimensions in infants and children: a systematic review of the literature. J Cardiothorac Vasc Anesth 2020;7:S1053-0770:30632-30637.
  70. Weese-Mayer DE, Berry-Kravis EM, Ceccherini I, Keens TG, Loghmanee DA, Trang H, et al. An official ats clinical policy statement: Congenital central hypoventilation syndrome: Genetic basis, diagnosis, and management. Am J Respir Crit Care Med 2010;181:626-644. https://doi.org/10.1164/rccm.200807-1069ST
  71. Wetmore RF. Tonsils and adenoids. In: Kliegman RM, Geme JS. Nelson Textbook of Pediatrics: Elsevier Health Sciences;2019. p.2198-2202.e2191.
  72. Wilson SL, Thach BT, Brouillette RT, Abu-Osba YK. Upper airway patency in the human infant: Influence of airway pressure and posture. J Appl Physiol Respir Environ Exerc Physiol 1980;48: 500-504.
  73. Winnebeck EC, Fischer D, Leise T, Roenneberg T. Dynamics and ultradian structure of human sleep in real life. Curr Biol 2018; 28:49-59 e45. https://doi.org/10.1016/j.cub.2017.11.063
  74. Wulbrand H, McNamara F, Thach BT. The role of arousal related brainstem reflexes in causing recovery from upper airway occlusion in infants. Sleep 2008;31:833-840. https://doi.org/10.1093/sleep/31.6.833