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Cited by 155Infant Development and Preterm CareCircadian rhythm and melatoninNeonatal Health and Biochemistry

Rest-Activity Patterns of Premature Infants Are Regulated by Cycled Lighting

Rivkees, Scott A., Mayes, Linda, Jacobs, Harris, Gross, Ian·2004·Pediatrics
DOI 10.1542/peds.113.4.833
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Abstract

Objectives. Many hospitalized premature infants are exposed to continuous dim lighting rather than to cycled lighting. However, we do not know whether dim lighting or low-intensity cycled lighting is more conducive to the development of rest-activity patterns that are in phase with the solar light-dark cycle. Thus, we examined the effects of nursery lighting conditions on the development of activity patterns in premature infants. Methods. Premature infants who were born at <32 weeks’ postmenstrual age and were medically stable in neonatal intensive care unit rooms were randomly assigned between 32 and 34 weeks’ postmenstrual age to either continuous dim lighting (<25 lux; duration 24 days; control group; n = 29) or cycled lighting (239 ± 29 lux, 7:00 am to 7:00 pm; <25 lux, 7:00 pm to 7:00 am; duration: 25 days; experimental group; n = 33). Activity was continuously monitored from enrollment until approximately 1 month after discharge from the hospital. Weight and head circumference were also assessed up to 6 months after discharge from the hospital. Results. Over the first 10 days at home, distinct day-night differences in activity were not seen in control subjects (D day-night: N 1.07 ± 0.02), but experimental group infants were more active during the day than at night (day-night: 1.25 ± 0.03). It was not until 21 to 30 days after discharge that day-night activity ratios in control infants matched those seen in experimental group infants shortly after discharge, yet even at this age, experimental group infants (day-night: 2.13 ± 0.19) were considerably more active during the day than at night as compared with control subjects (day-night: 1.43 ± 0.09). Conclusion. Exposure of premature infants to low-intensity cycled lighting in the hospital nursery induces distinct patterns of rest-activity that are apparent within 1 week after discharge. In comparison, the appearance of distinct patterns of rest and activity are delayed in infants who are exposed to continuous dim lighting in the hospital. These observations show that day-night rhythms in activity patterns can be detected shortly after discharge to home in premature infants and that the circadian clock of developing infants is entrained by cycled lighting.

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  • Premature infants kept in regular light-dark conditions also fed orally sooner and spent fewer days on ventilator assistance, but had similar motor coordination compared with infants under continuous near darkness in the NICU (28-32 weeks of gestation).

    “Premature infants kept in regular light–dark conditions also fed orally sooner and spent fewer days on ventilator assistance, but had similar motor coordination compared with infants under continuous near darkness in the NICU (28–32 weeks of gestation)79–85.”

    From Rhythms of life: circadian disruption and brain disorders across the lifespan (2019) · cites this paper as [85]

  • Regular light-dark schedules also support the maturation of rest-activity, sleep-wake and melatonin rhythms earlier in premature infants.

    “Regular light–dark schedules also support the maturation of rest–activity, sleep–wake and melatonin rhythms earlier in premature infants71,85.”

    From Rhythms of life: circadian disruption and brain disorders across the lifespan (2019) · cites this paper as [85]

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Authors
Rivkees, S. A., Mayes, L., Jacobs, H., & Gross, I.
Affiliations
  • Yale University (US)
  • Bridgeport Hospital (US)
ORCID
Venue
Pediatrics
Publisher
American Academy of Pediatrics (AAP)
Published
2004-04-01
Volume
113
Issue
4
Pages
833-839
ISSN
  • 0031-4005 (ISSN-L)
  • 1098-4275
DOI
10.1542/peds.113.4.833
OpenAlex
W2088289468
Cited by
155
References
31
Citations by year
2026: 3 · 2025: 6 · 2024: 5 · 2023: 8 · 2022: 10 · 2021: 5 · 2020: 2 · 2019: 7 · 2018: 4 · 2017: 11 · 2016: 8 · 2015: 6 · 2014: 12 · 2013: 8 · 2012: 4
FWCI
7.94
Type
journal article
Language
en
Open access
closed
Locations
  • PEDIATRICS (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • National Institutes of Health (5k02da000222-10)
  • National Institute on Drug Abuse (R01DA006025, R01 DA06025, K02-DA00222)
  • National Institute of Neurological Disorders and Stroke (R01NS032624, R01NS32624)
  • National Center for Research Resources (RR06022)
  • Eunice Kennedy Shriver National Institute of Child Health and Human Development (P01 HD03008, P01HD003008)
Topics
  • Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Infant Development and Preterm Care
  • Life Sciences › Neuroscience › Endocrine and Autonomic Systems › Circadian rhythm and melatonin
  • Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Neonatal Health and Biochemistry
Keywords
preterm infants, rest-activity patterns, circadian rhythm, dim lighting, circadian entrainment, neonatal intensive care
MeSH terms
Activity Cycles, Circadian Rhythm, Humans, Infant, Newborn, Infant, Premature, Intensive Care Units, Neonatal, Lighting, Sleep, Multivariate Analysis

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