This issue of Journal of Perinatal & Neonatal Nursing is a special issue covering the expansive theme of sleep. How sleep affects new mothers, newborns, as well as various health professionals will be examined. The perinatal section presents new research on sleep needs in mothers. I am indebted to Dr Kathryn Lee who has provided the guidance for the majority of the perinatal manuscripts and who is coauthor on many of the articles in the perinatal section.
Owens opens the issue with an article on sleep loss in health professionals. Sleep loss and impairments related to fatigue are common findings among professionals working in healthcare settings. The effects of sleep on job, personal health, patient safety, and other effects are noted. Owens presents the challenges of sleep deprivation and shares fatigue management strategies successful in other settings.
Beebe and Lee present data on sleep in late pregnancy. Sleep disturbance is a common complaint in late pregnancy. The purpose of this study was to evaluate the amount of sleep obtained in the 5 days preceding childbirth and note the relationship between sleep in this time frame and both pain and fatigue during early labor. Results from this study can be used to advise women in late pregnancy about expected sleep patterns and measures to optimize sleep and rest.
Lee and Lee describe sleep and fatigue during the first week of postpartum recovery, and compare women post-cesarean delivery with women post-vaginal delivery while their infants were hospitalized in intensive care. This cross-sectional, descriptive, exploratory study involved 21 postpartum mothers.
Kennedy and Lee present a qualitative study of new mothers relative to their experience of sleep during pregnancy and during the immediate months of becoming a new mother. Semistructured, audio-taped interviews were conducted in which women were asked to describe their sleep experience. Kennedy and Lee describe strategies to assist new mothers with sleep needs.
Goyal and Lee studied the patterns of sleep disruption and depressive symptoms in new mothers. This study describes the patterns of sleep disturbance and depressive symptoms in childbearing women from the third trimester through the postpartum period.
Sleep is essential for the growth and development of the newborn. For those infants born early and/or requiring intensive care, sleep becomes increasingly vital, yet more elusive within the neonatal intensive care unit environment. The neonatal topics for this sleep issue include a comprehensive overview of the description of sleep states with evidence-based clinical implementations for neonatal care. Dr Kathleen VandenBerg provides an introduction to the state system as a developmental process setting the stage with specific definitions of sleep states and how they affect the physiological needs of the infant.
Bertelle et al represent an international multidisciplinary perspective with their research study investigating the influence of the NIDCAP approach toward developmental care on the quality and duration of the preterm infant's sleep. They also explored the relationship between clinically skilled observations of sleep states and the physiological polysomnography data of infants in their study in an effort to further understand the biological role of sleep. As one of the evidence-based strategies to enhance sleep in the preterm infant, Smith shares the journey of a large newborn intensive care unit's implementation of a skin-to-skin holding policy. The staff learned an appreciation for their role in collaborating with parents in enhancing and facilitating the infant's sleep.
The topic of sleep in newborn infants would not be complete without the overview provided by Esposito et al on the neonatal nurse's roles as educators, models of care, and collaborators in the prevention of sudden infant death syndrome (SIDS). They review the most recent recommendations on this issue, and explore the frequent barriers nurses express in adhering to current guidelines. In addition, this article provides a wonderful list of resources for nurses to assist in their implementation of SIDS prevention practices well before discharge. Glenn and Quillin present an intriguing study using a correlational design comparing the relative influence of the parental socioeconomic status on aspects of neonatal care related to feeding and sleep. Their findings regarding the practice of cosleeping in relation to each parent's socioeconomic status has more influence is especially interesting in light of recommendations of Esposito et al for prevention of SIDS.
The significance of the collaboration between the neonatal nurse and the infant's parents is an integral message within each of these topics. Each author reinforces that the provision of optimal support to infants must be done within the context of their families. Within a best practice model, neonatal nurses, in collaboration with multidisciplinary colleagues and parents, facilitate the infant's sleep in order to not only grow and develop but also thrive.
Diane J. Angelini, EdD, CNM, FACNM, FAAN, CNAA, BC, Perinatal Editor
gretchen Lawhon, PhD, RN, Neonatal Guest Editor