TY - JOUR
T1 - Maternal voice and infant sleep in the neonatal intensive care unit
AU - Shellhaas, Renée A.
AU - Burns, Joseph W.
AU - Barks, John D.E.
AU - Hassan, Fauziya
AU - Chervin, Ronald D.
N1 - Funding Information:
FINANCIAL DISCLOSURE: Dr Shellhaas receives royalties from UpToDate for authorship of topics related to neonatal seizures, serves as a consultant to the Epilepsy Study Consortium, and receives research support funding from the Patient-Centered Outcomes Research Institute, the National Institutes of Health, the Pediatric Epilepsy Research Foundation, and the University of Michigan; Dr Barks receives grant funding from the National Institutes of Health; Dr Hassan has previously served as a consultant for Biogen and has received research funding from Jazz Pharmaceuticals; Dr Chervin has had financial relationships with the American Academy of Sleep Medicine, UpToDate, and Cambridge University Press, is a member of the boards for the International Pediatric Sleep Association and the not-for-profit Sweet Dreamzzz, receives research support from the National Institutes of Health, and is named in patents and copyrighted material owned by the University of Michigan that concerns the identification and treatment of sleep disorders; and Dr Burns has indicated he has no financial relationships relevant to this article to disclose.
Funding Information:
FUNDING: Supported by National Institutes of Health and the Michigan Institute for Clinical and Health Research (R21HD083409; UL1TR002240). Funded by the National Institutes of Health (NIH).
Publisher Copyright:
© 2019 by the American Academy of Pediatrics
PY - 2019
Y1 - 2019
N2 - BACKGROUND: Approximately 10% of US newborns require a NICU. We evaluated whether the NICU acoustic environment affects neonatal sleep and whether exposure to the mother's voice can modulate that impact. METHODS: In a level IV NICU with single-infant rooms, 47 neonates underwent 12-hour polysomnography. Their mothers were recorded reading children's books. Continuous maternal voice playback was randomized to either the first or second 6 hours of the polysomnogram. Regression models were used to examine sleep-wake stages, entropy, EEG power, and the probability of awakening in response to ambient noise during and without voice playback. RESULTS: After epochs with elevated noise, the probability was higher with (versus without) maternal voice exposure of neonates staying asleep (P = .009). However, the 20 neonates born at $35 weeks' gestation, in contrast to those born at 33 to 34 weeks, showed an age-related increase in percent time awake (R2 = 0.52; P, .001), a decrease in overall sleep (R2 = 0.52; P, .001), a reduction in rapid eye movement sleep bouts per hour (R2 = 0.35; P = .003), and an increase in sleep-wake entropy (R2 = 0.52; P, .001) all confined solely to the 6 hours of maternal voice exposure. These associations remained significant (P = .02 to P, .001) after adjustment for neurologic examination scores and ambient noise. CONCLUSIONS: Hospitalized newborns born at $35 weeks' gestation but not at 33 to 34 weeks' gestation show increasing wakefulness in response to their mother's voice. However, exposure to the mother's voice during sleep may also help protect newborns from awakening after bursts of loud hospital noise.
AB - BACKGROUND: Approximately 10% of US newborns require a NICU. We evaluated whether the NICU acoustic environment affects neonatal sleep and whether exposure to the mother's voice can modulate that impact. METHODS: In a level IV NICU with single-infant rooms, 47 neonates underwent 12-hour polysomnography. Their mothers were recorded reading children's books. Continuous maternal voice playback was randomized to either the first or second 6 hours of the polysomnogram. Regression models were used to examine sleep-wake stages, entropy, EEG power, and the probability of awakening in response to ambient noise during and without voice playback. RESULTS: After epochs with elevated noise, the probability was higher with (versus without) maternal voice exposure of neonates staying asleep (P = .009). However, the 20 neonates born at $35 weeks' gestation, in contrast to those born at 33 to 34 weeks, showed an age-related increase in percent time awake (R2 = 0.52; P, .001), a decrease in overall sleep (R2 = 0.52; P, .001), a reduction in rapid eye movement sleep bouts per hour (R2 = 0.35; P = .003), and an increase in sleep-wake entropy (R2 = 0.52; P, .001) all confined solely to the 6 hours of maternal voice exposure. These associations remained significant (P = .02 to P, .001) after adjustment for neurologic examination scores and ambient noise. CONCLUSIONS: Hospitalized newborns born at $35 weeks' gestation but not at 33 to 34 weeks' gestation show increasing wakefulness in response to their mother's voice. However, exposure to the mother's voice during sleep may also help protect newborns from awakening after bursts of loud hospital noise.
UR - http://www.scopus.com/inward/record.url?scp=85071783284&partnerID=8YFLogxK
U2 - 10.1542/peds.2019-0288
DO - 10.1542/peds.2019-0288
M3 - Article
C2 - 31409691
AN - SCOPUS:85071783284
SN - 0031-4005
VL - 144
JO - Pediatrics
JF - Pediatrics
IS - 3
M1 - 20190288
ER -