Abstract
Knowledge is recently building regarding the factors that affect the development of an optimal sleep-wake cycle. Fetuses near term experience arousal fluctuations and sleep episodes already in the darkness of the womb. Yet, the factors that allow for a smooth emergence of an optimal sleep wake cycle are the conditions that place newborn at higher risk to develop sleep disorders are not yet fully understood. The current chapter proposes an integrative model for the development of circadian sleep-wake rhythms in preterm infants. This model is based on a comprehensive review of the basic science literature as well as clinical work with at-risk preterm infants. This integrative model proposed a three source risk source: 1) infant dependent neurobiological vulnerability risk, such as brainstem mediated functional disability; 2) a familial source that entails genetic predispositions, parental style and support resources; and 3) an environmental stimulation source, such as excessive NICU related stimulation and handling. These three realms act as main effects and interact with the infants' prenatal and postnatal age and with the infants' self-regulation mechanisms. The manner in which these sources operate and interact lead to directions of interventions that ameliorate the development of circadian sleep-wake rhythm deficit in infants born atrisk for sleep disorders. The chapter details each component of the model and illuminates the complexity of the interactions involved in it to deepen the understanding the mechanisms involved in early organization of sleep-wake rhythms in infants.
| Original language | English |
|---|---|
| Title of host publication | Biological Clocks |
| Subtitle of host publication | Effects on Behavior, Health and Outlook |
| Publisher | Nova Science Publishers, Inc. |
| Pages | 101-120 |
| Number of pages | 20 |
| ISBN (Print) | 9781607412519 |
| State | Published - Jan 2011 |