Preterm newborns sleep better in NICU while hearing their mother's voice

Novel strategy can help improve sleep in a noisy neonatal intensive care unit

June 6, 2018

Science Daily/American Academy of Sleep Medicine

Hearing a recording of their mother's voice may help neonates maintain sleep while in the neonatal intensive care unit (NICU), according to preliminary data from a new study.

About 10 percent of U.S. newborns require treatment in a NICU, which is a noisy environment that could influence the development of newborn sleep patterns. This study explored the possibility that infants' exposure to their mother's voice in the NICU could modulate that impact.

Results indicate that newborns in a NICU were less likely to be awakened by noises when a recording of their mother's voice was playing. The study also found that newborns born at or after 35 weeks gestation show sleep-wake patterns that appear to respond increasingly with age to recorded maternal voice exposure. Similar associations were not found for infants born before 35 weeks gestation.

"Environmental noise can be remarkably high in the NICU and may influence neonatal sleep patterns," said principal investigator Dr. Renée Shellhaas, a clinical associate professor of pediatrics in the division of Pediatric Neurology at the University of Michigan. "Exposure to a mother's voice recording may insulate NICU patients from some of the impact of unavoidable noise by reducing the likelihood of wakefulness during the highest peak noise levels."

The study in a NICU involved 20 neonates born at or after 35 weeks gestation and 27 born preterm at 33-34 weeks. Their mothers were recorded reading children's books. The neonates underwent a 12-hour sleep evaluation by attended polysomnography. Each mother's recording was randomized to be played continuously for her child during either the first or second 6-hours of the polysomnogram.

Sleep-wake stage distributions, entropy, and EEG power were calculated for each 6-hour block. Quantitative sleep measures were evaluated as a function of gestational age, with adjustment for neurological examination scores. Data were compared for polysomnogram epochs with, versus without, the recorded maternal voice playing.

Newborn infants who are ill or born prematurely may require extended care in a neonatal ICU during a time of critical brain development. Shellhaas noted that interventions designed to improve sleep in newborns who require intensive care may need to be tailored according to gestational age.

"Our study results suggest an intervention as simple as playing a recording of the mother reading stories may result in improved sleep," said Shellhaas. "However, the impact of such interventions appears to be more significant for newborns who are near term gestation than for more premature infants."

https://www.sciencedaily.com/releases/2018/06/180606170205.htm

Study Supports Notion of Leaving Infants to Cry Themselves Back to Sleep

January 2, 2013

Science Daily/Temple University

Today, mothers of newborns find themselves confronting a common dilemma: Should they let their babies "cry it out" when they wake up at night? Or should they rush to comfort their crying little one?

"By six months of age, most babies sleep through the night, awakening their mothers only about once per week. However, not all children follow this pattern of development," said Weinraub, an expert on child development and parent-child relationships.

Of the babies that awoke, the majority were boys. These transitional sleepers also tended to score higher on an assessment of difficult temperament which identified traits such as irritability and distractibility. And, these babies were more likely to be breastfed. Mothers of these babies were more likely to be depressed and have greater maternal sensitivity.

The findings suggest a couple of things, said Weinraub. One is that genetic or constitutional factors such as those that might be reflected in difficult temperaments appear implicated in early sleep problems. "Families who are seeing sleep problems persist past 18 months should seek advice," Weinraub said.

Another takeaway is that it is important for babies to learn how to fall asleep on their own. "When mothers tune in to these night time awakenings and/or if a baby is in the habit of falling asleep during breastfeeding, then he or she may not be learning to how to self-soothe, something that is critical for regular sleep," she said.

According to Weinraub, the mechanism by which maternal depression is connected to infant awakenings is an area that would benefit from further research. On the one hand, Weinraub said, it's possible that mothers who are depressed at six and 36 months may have been depressed during pregnancy and that this prenatal depression could have affected neural development and sleep awakenings. At the same time, it's important to recognize that sleep deprivation can, of course, exacerbate maternal depression, she said.

"Because the mothers in our study described infants with many awakenings per week as creating problems for themselves and other family members, parents might be encouraged to establish more nuanced and carefully targeted routines to help babies with self-soothing and to seek occasional respite," said Weinraub.

http://www.sciencedaily.com/releases/2013/01/130102161811.htm