Impact of hands-on care on infant sleep in the neonatal intensive care unit

Levy, Jennifer; Hassan, Fauziya; Plegue, Melissa A.; Sokoloff, Max D.; Kushwaha, Juhi S.; Chervin, Ronald D.; Barks, John D.E.; Shellhaas, Renée A.

doi:10.1002/ppul.23513

Cited by 85Infant Development and Preterm CareInfant Health and DevelopmentNeonatal and fetal brain pathology

Impact of hands-on care on infant sleep in the neonatal intensive care unit

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Levy, Jennifer, Hassan, Fauziya, Plegue, Melissa A., Sokoloff, Max D., Kushwaha, Juhi S., Chervin, Ronald D., Barks, John D.E., Shellhaas, Renée A.·2017·Pediatric Pulmonology

DOI 10.1002/ppul.23513PMC PMC5600897

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Abstract

STUDY OBJECTIVES: Sleep disruption is increasingly recognized in hospitalized patients. Impaired sleep is associated with measureable alterations in neurodevelopment. The neonatal intensive care unit (NICU) environment has the potential to affect sleep quality and quantity. We aimed: (i) to determine the frequency and duration of hands-on care, and its impact on sleep, for NICU patients; and (ii) to assess the incidence of respiratory events associated with handling for a cohort of sick neonates. METHODS: Term and near-term neonates admitted to the NICU and at risk for cerebral dysfunction due to severity of illness or clinical suspicion for seizures underwent attended, bedside polysomnography. Continuous polysomnogram segments were analyzed and data on handling, infant behavioral state, and associated respiratory events were recorded. RESULTS: Video and polysomnography data were evaluated for 25 infants (gestational age 39.4 ± 1.6 weeks). The maximum duration between handling episodes for each infant was 50.9 ± 26.2 min, with a median of 2.3 min between contacts. Handling occurred across all behavioral states (active sleep 29.5%; quiet sleep 23.1%; awake 29.9%; indeterminate 17.4%; P = 0.99). Arousals or awakenings occurred in 57% of contacts with a sleeping infant. Hypopnea, apnea, and oxygen desaturation occurred with 16%, 8%, and 19.5% of contacts, respectively. Hypopnea was most likely to occur following contact with infants in active sleep (28%; P < 0.001). CONCLUSIONS: Infants in the NICU experience frequent hands-on care, associated with disturbances of sleep and respiration. The potential health and developmental impact of these disturbances merits study, as strategies to monitor sleep and minimize sleep-disordered breathing might then improve NICU outcomes. Pediatr Pulmonol. 2017;52:84-90 © 2016 Wiley Periodicals, Inc.

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Few studies report the correlation of PAT with SBP in infants, mainly in the context of sleep studies and as a screening method rather than a core clinical tool, and none report measurements of PTT in this critical care population.
“Few studies report the correlation of PAT with SBP in infants, mainly in the context of sleep studies and as screening method rather than a core clinical tool.35,36 None report measurements of PTT in this critical care population.”
From Skin-interfaced biosensors for advanced wireless physiological monitoring in neonatal and pediatric intensive-care units (2020) · cites this paper as [36]
The Polysomnography and Discussion sections describe infant sleep monitoring and respiratory events, but do not discuss pulse arrival time (PAT), its correlation with systolic blood pressure (SBP), or its use as a screening method. Searches for PAT/SBP and pulse transit time (PTT) found no passage addressing those claims or establishing that no PTT measurements have been reported in this population. (LLM, conf=0.76)
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Authors: Levy, J., Hassan, F., Plegue, M. A., Sokoloff, M. D., Kushwaha, J. S., Chervin, R. D., Barks, J. D. E., & Shellhaas, R. A.
Affiliations: University of Michigan (US)
Wayne State University (US)
Corresponding author: Shellhaas, Renée A.
ORCID: Plegue, Melissa A.
Chervin, Ronald D.
Barks, John D.E.
Shellhaas, Renée A.
Venue: Pediatric Pulmonology
Publisher: Wiley
Published: 2016-06-30
Volume: 52
Issue: 1
Pages: 84-90
ISSN: 1099-0496 (ISSN-L)
8755-6863
DOI: 10.1002/ppul.23513
PMC: PMC5600897
OpenAlex: W2465157982
Cited by: 85
References: 19
Citations by year: 2026: 4 · 2025: 13 · 2024: 3 · 2023: 5 · 2022: 11 · 2021: 12 · 2020: 26 · 2019: 1 · 2018: 4 · 2017: 5 · 2016: 1
FWCI: 4.26
Type: journal article
Language: en
Open access: green
www.ncbi.nlm.nih.gov
Licence: doi.wiley.com/10.1002/tdm_license_1 (tdm)
onlinelibrary.wiley.com/termsAndConditions (vor)
Locations: Pediatric Pulmonology (publishedVersion)
PubMed (publishedVersion)
PubMed Central (acceptedVersion)
Deep Blue (University of Michigan) (submittedVersion)
Funders: National Institutes of Health (NICHD) (5K23HD068402)
Topics: Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Infant Development and Preterm Care
Health Sciences › Health Professions › Pharmacy › Infant Health and Development
Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Neonatal and fetal brain pathology
Keywords: infant sleep, neonatal intensive care unit, sleep disruption, sleep-disordered breathing, hypopnea, apnea, oxygen desaturation, arousal, active sleep, quiet sleep, neonatal handling, polysomnography, brain development
MeSH terms: Female, Gestational Age, Humans, Infant, Infant, Newborn, Intensive Care Units, Neonatal, Male, Respiration, Sleep, Sleep Apnea Syndromes, Polysomnography

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