Preterm babies will wear ‘swimming caps’ containing sensors to measure the quality of their sleep.
A new landmark study, funded by the charity Action Medical Research is investigating the impact interruptions in sleep cycles in special care baby units have on the development of brain activity in preterm babies. There is increasing evidence that the different sleep cycles in babies known as active and quiet sleep play an important role in the early development of the brain.[1] Spontaneous brain activity in preterm babies is important for new brain connections to be made and is associated with spontaneous changes in blood flow in different parts of the brain.[1]
In this new study, changes in blood flow and oxygen levels will be measured in different parts of the brain using a non-invasive wearable technology, similar to a swimming cap, worn on the head, during the quiet and active sleep cycles of very preterm and healthy term infants.
The study is significant as preterm babies develop in an environment that is very different from the womb. The frequent and often painful procedures, bright lights and loud noises in the SCBU interrupt the natural sleep cycles which are essential for normal brain development. Preterm birth and low birth weight (LBW) have also been identified as risk factors for psychiatric disorders, including emotional disorders, attention deficit/ hyperactivity disorders (ADHD), and autism spectrum disorders.[2]
Professor Topun Austin, Neonatal Intensive Care Unit, Cambridge University Hospitals NHS Foundation Trust says: “The results from this study could have long-term implications for the care of preterm babies as this will increase understanding of the sleep states that promote the development of the brain. Ultimately this could lead to a traffic light system next to cots with a red light to indicate a baby is in active or quiet sleep and should not be disturbed and a green light when the baby is transitioning between sleep states, indicating that the baby can be woken up for tests, feeding or other care.”
This research is needed as in the UK one in every 13 babies, around 55,000 are born too soon – before 37 weeks of pregnancy, and around 8,000 babies are born before 32 weeks.[3][4][5] Advances in treatment have led to improved survival, however preterm babies have an increased risk of long-term neurodevelopmental complications.[6] Very preterm babies, born before 32 weeks, are at a higher risk of developing behavioural and emotional problems and poor sleep.[7]
The infant sleep cycle lasts between 30-90 minutes and comprises mainly of so-called ‘active’ and ‘quiet’ sleep segments, which can be detected as early as 25-27 weeks’ gestation.[8] The preterm infant will spend most of their time asleep in active sleep. In contrast, full-term infants spend 50% of total sleep in active sleep and periods of wakefulness steadily increase during this time. There is increasing evidence that active sleep is intimately linked to the spontaneous neuronal burst of activity seen in preterm infants.[1]
Dr Caroline Johnston, Senior Research Manager, Action Medical Research says: "We have and are continuing to fund groundbreaking research to reduce the risk of premature birth. The long-term impact of premature birth can persist into adulthood. This project could lead to effective interventions to improve the special baby care environment for preterm babies with the aim of improving longer-term outcomes for children born too early.”
For more about Action Medical Research please visit www.action.org.uk.
Notes to editors
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Action Medical Research is the leading UK-wide charity dedicated to saving and changing children’s lives through medical research. For 70 years we’ve helped pioneer ways to prevent disease and develop treatments benefiting millions of people. Our research has helped to beat polio in the UK, develop ultrasound in pregnancy, fight meningitis and prevent stillbirths. But we urgently need to develop more new treatments and cures for sick babies and children and we can’t do it without you.
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References
[1] Arichi T, Whitehead K, Barone G, Pressler R, Padormo F, Edwards AD, Fabrizi L. Localization of spontaneous bursting neuronal activity in the preterm human brain with simultaneous EEGfMRI. Elife. 2017 Sep 12;6. pii: e27814. doi: 10.7554/eLife.27814.
[2] Johnson S. Marlow N. Preterm Birth and Childhood Psychiatric Disorders. Pediatric Research 2011; 69 (5) Pt.
[3] Office for National Statistics Birth Characteristics: Table 8: Births by gestational age at birth and ethnicity of live births, 2020 Birth characteristics - Office for National Statistics (ons.gov.uk) [Accessed09Mar22].
[4] Public Health Scotland – Maternity and Births in Scottish hospitals Year ending 31March2021 https://publichealthscotland.scot/publications/births-in-scottish-hospitals/births-in-scottish-hospitals-year-ending-31-march-2021/ (Table 7.1) [Accessed 27Jun22].
[5] Northern Ireland Statistics and Research Agency – Births, Deaths and Marriages, Registrar General Annual Report 2020 Births Section 3 - Births_Tables_2020_Final.ods (live.com) [Accessed 09Mar22].
[6] Kidokoro H, Anderson PJ, Doyle LW, Woodward LJ, Neil JJ, Inder TE. Brain injury and altered brain growth in preterm infants: predictors and prognosis. Pediatrics. 2014;134(2):e444-453.; doi:10.1542/peds.2013-2336.
[7] Perkinson-Gloor N, Hagmann-von Arx P, Brand S, et al. The role of sleep and the hypothalamic pituitary-adrenal axis for behavioral and emotional problems in very preterm children during middle childhood. J Psychiatr Res. 2015;60:141-147. doi:10.1016/j.jpsychires.2014.10.00.
[8] Scher MS. Ontogeny of EEG-sleep from neonatal through infancy periods. Sleep Med. 2008;9(6):615-636. doi:10.1016/j.sleep.2007.08.014.