The ontogenetic framework onto which a child's sleep is constructed undergoes significant developmental alterations during early life. Sleep state behaviors, in large part, reflect continuities from fetal through neonatal time periods. Major changes in sleep organization subsequently occur throughout infancy. Maturational expressions of sleep behaviors must be understood by the pediatric neurologist before specific physiologic phenomena can be assessed as transient sleep disturbances or clinically relevant sleep disorders. The first part of this two-part review article focuses on the major aspects of developmental sleep physiology in the first few months of life. Recognition of age-specific electroencephalographic/polysomnographic patterns will facilitate the child neurologist's evaluation of the newborn with suspected seizures and interictal encephalopathies, as well as the prediction of neurologic sequelae. (J Child Neurol 1998;13:467-474).
Get full access to this article
View all access options for this article.
References
1.
Hobson JA, Lydic R., Baghdoyan HA: Evolving concepts of sleep cycle generation: From brain centers to neuronal populations. Behav Brain Sci1986 ;9:371-390.
2.
Culebras A (ed): The neurology of sleep. Neurology1992;42: (Suppl 6).
3.
Comer MA: Ontogeny of brain sleep mechanisms, in McGinty DJ, et al (eds): Brain Mechanisms of Sleep. New York, Raven Press, 1985.
4.
Prechtl HFR (ed): Continuity of Neural Functions from Prenatal to Postnatal Life. London, Spastics International Medical Publications, 1984.
5.
Lombroso CT: Neonatal polygraphy in full-term and premature infants: A review of normal and abnormal findings. J Clin Neurophysiol1985;2:105-155.
6.
Scher MS, Guthrie R., Krieger D., et al: Maturational aspects of sleep from birth through early childhood , in Beckerman RC, Brouillette RT, Hunt CE (eds): Respiratory Control Disorders in Infants and Children . Baltimore, Williams & Wilkins , 1992, pp 89-111.
7.
Busby K., Pivik RT: Auditory arousal thresholds during sleep in hyperkinetic children . Sleep1985;8:332-341.
8.
Scher MS, Steppe DA, Banks DL, et al: Maturational trends of EEG-sleep measures in the healthy preterm neonate. Pediatr Neurol1995;12:314-322.
9.
Scher MS, Steppe DA, Banks DL: A dysmaturity index derived from EEG-sleep analyses to document brain adaptation to conditions of prematurity. Ann Neurol1996 ;40:320.
10.
Bell MA, Fox NA: The relations between frontal brain electrical activity and cognitive development during infancy. Child Dev1992 ; 63:1142-1163.
11.
Thatcher RW : Cyclic cortical reorganization during early childhood. Brain Cogn1992;20:24-50.
12.
Scher MS: Normal sleep in preterm and fullterm infants, in Bodensteiner JB, Kotagal S (eds): Seminars in Pediatric Neurology, vol 3. Philadelphia, WB Saunders, 1996, pp 2-12.
13.
Anders T, Emde R, Parmelee A (eds): A Manual of Standardized Terminology, Technique and Criteria for Scoring States of Sleep and Wakefulness in Newborn Infants. Los Angeles , UCLA Brain Information Service/RRI Publications Office, NINDS Neurological Information Network, 1971.
14.
Pope SS, Stockard JE, Bickford RG: Atlas of Neonatal Electro-encephalopathy. New York , Raven Press, 1992.
15.
Scher MS: Neurophysiological assessment of brain function and maturation. I: A measure of brain adaptation in high risk infants. Pediatr Neurol1997; 16:191-198.
16.
Scher MS, Dokianakis SG, Steppe DA, et al: Computer classification of state in healthy preterm neonates . Sleep1997;20:132-141.
17.
Amiel-Tison C., Pettigrew AG: Adaptive changes in the developing brain during intrauterine stress. Brain Dev1991 ;13:67-76.
18.
Holmes DL, Logan WJ, Kirkpatrick BV, et al: Central nervous system maturation in the stressed premature . Ann Neurol1979;6: 518-522.
19.
Tharp BR, Scher MS, Clancy RR: Serial EEGs in normal and abnormal infants with birth weights less than 1200 grams—A prospective study with long term follow-up. Neuropediatrics1989;20:815-819.
20.
Hahn JS, Tharp BR: The dysmature EEG pattern in infants with bronchopulmonary dysplasia and its prognostic implications. Electroencephalogr Clin Neurophysiol1990;76:106-113.
21.
Scher MS, Richardson G., Salerno DG, Guthrie RD: Sleep architecture and continuity measures in neonates with chronic lung disease . Sleep1992;15:195-201.
22.
Scher MS, Richardson GA, Coble PA, et al: The effects of prenatal alcohol and marijuana exposure: Disturbances in neonatal sleep cycling and arousal. Pediatr Res1988;24:101-105.
23.
Monod N., Pajot N., Guidasci S.: The neonatal EEG: Statistical studies and prognostic value in full-term and preterm babies. Electroencephalogr Clin Neurophysiol1972;32:529-544.
24.
Tharp BR, Cukier F., Monod N.: The prognostic value of the electroencephalogram in premature infants . Electroencephalogr Clin Neurophysiol1981 ;51:219-236.
25.
Freudigman KA, Thoman EB: Infant sleep during the first postnatal day: An opportunity for assessment of vulnerability. Pediatrics1993;92:373-379.
26.
Scher MS, Steppe DA, Banks DL: Postnatal adaptation of brain function in fullterm neonates as assessed by EEG-sleep analyses. Sleep1995;18:531-535.
27.
Scher MS, Steppe DA, Banks DL: Prediction of lower developmental performances of healthy neonates by neonatal EEG-sleep measures. Pediatr Neurol1996; 14:137-144.
28.
Martin RJ, Miller MJ, Waldemar AC: Medical progress. Pathogenesis of apnea in preterm infants. J Pediatr1986;109:733-784.
29.
Gould JB, Lee AFS, James O., et al: The sleep state characteristics of apnea during infancy. Pediatrics1976;59:182-189.
30.
Bruhn FW, Mokrohisky ST, McIntosh K.: Apnea associated with respiratory syncytial virus infection in young infants . JPediatr1977; 90:382-390.
31.
Scher MS, Aso K., Beggarly ME, et al: Electrographic seizures in preterm and full-term neonates: Clinical correlates, associated brain lesions, and risk for neurological sequelae. Pediatrics1993; 91:128-134.
32.
Hakamada S. , Watanabe K., Hara K., Miyazaki S.: Development of the motor behavior during sleep in newborn infants. Brain Dev1981;3:345-350.
33.
Lombroso CT , Fejerman W.: Benign myoclonus of early infancy . Ann Neurol1977;1:138-143.
34.
Scher MS: Pathological myoclonus of the newborn: Electrographic and clinical correlations . Pediatr Neurol1985; 1: 342-348.
35.
Shuper A., Zalzberg J., Weitz R., Mimouni M.: Jitteriness beyond the neonatal period: A benign pattern of movement in infancy . J Child Neurol1991;6:243-245.
36.
Herbst JJ, Minton SD, Book LS: Gastroesophageal reflux causing respiratory distress and apnea in newborn infants. J Pediatr1979;95:763-768.
37.
Harper RM: State-related physiological changes and risk for the sudden infant death syndrome . Aust Paediatr J1986; (Suppl):55-58.
38.
Filiano JJ, Kinney HC: A perspective on neuropathologic findings in victims of the sudden infant death syndrome: The triple-risk model. Biol Neonate1994;65:194-197.
39.
Gilbert R., Rudd P., Berry PJ, et al: Combined effort of infection and heavy wrapping on the risk of sudden unexpected infant death. Arch Dis Child1992;67:171-177.
40.
American Academy of Pediatrics: Positioning and sudden infant death syndrome (SIDS): Update. Pediatrics1996;98:1216-1218.
41.
Glotzbach SF , Ariagno RL, Harper RM: Sleep and the sudden infant death syndrome , in Ferber R, Kryger M (eds): Principles and Practice of Sleep Medicine in the Child. Philadelphia, WB Saunders, 1995, pp 231-244.
42.
Filiano JJ, Kinney HC: Arcuate nucleus hypoplasia in the sudden infant death syndome. J NeuropathotExp Neurol1992;51:394-403.
43.
Kinney HC, Brody BA, Finkelstein DM, et al: Delayed central nervous system myelination in the sudden infant death syndrome. J Neuropathol Exp Neurol1991;30:29-48.
44.
Takashima S. , Beck LE: Delayed dendrite development of catecholaminergic neurons in the ventrolateral medulla of children who died of the sudden infant death syndrome. Neuropediatrics1991;22:97-99.
45.
Kempe A., Wise PH, Wampler NS, et al: Risk status at discharge and cause of death for postneonatal infant deaths: A total population study. Pediatrics1997;99:338-344.
