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Evidence-Based Practice Beliefs: Promoting and Protecting Infant Sleep
Kimberly A. Allen PhD, RN
Jacqueline Mcgrath

$3.95
Advances in Neonatal Care
October 2012 
Volume 12  Number 5
Pages 288 - 291
 
  PDF Version Available!

ABSTRACT
Sleep is essential to brain development and maturation in infants.1 Infants require extensive sleep for further development of the neurosensory systems; structural development of the hippocampus, pons, brainstem, and midbrain2; and optimizing physical growth.3 Protecting infant sleep is a critical component of providing developmentally appropriate care for premature and full-term infants in the neonatal intensive care unit (NICU) because many of these infants are hospitalized during one of the most critical periods of brain development.4 To best provide developmentally appropriate care, identification of sleep-wake states is necessary.Sleep-wake states can be distinguished through both electroencephalography (EEG) and biobehavioral techniques. Electroencephalography can be useful in the detection of sleep-wake states and cycles in infants, but most nurses are not trained to interpret EEGs. Generally, nurses use observation of biobehavioral responses to determine changes in sleep-wake states. Sleep-wake states are observable behaviors regulated by neuronal-controlled physiologic mechanisms recurring longitudinally in infants.5 Sleeping and waking evolve into distinct states as the brain continues to develop the neural structures and connections necessary for cyclical synchronization with other physiologic mechanisms (eg, heart rate variability, thermoregulation).5 If the infant's brain has not reached the necessary stage of development to perform certain behaviors, the infant is unable to display the overt behaviors associated with various sleep-wake states. Thus, as premature infants develop so do their behaviors displayed through the range of sleep-wake states in their behavioral repertoire.6Scales to describe sleep-wake states have been used for decades to better understand how the infant interacts with his environment.7 The underlying objective of the scales is to identify infant behaviors and their relationship to phases of development that are portrayed through

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