Unobtrusive sleep state measurements in preterm infants - A review.
Sleep is important for the development of preterm infants. During sleep, neural connections are formed and the development of brain regions is triggered. In general, various rudimentary sleep states can be identified in the preterm infant, namely active sleep (AS), quiet sleep (QS) and intermediate sleep (IS). As the infant develops, sleep states change in length and organization, with these changes as important indicators of brain development. As a result, several methods have been deployed to distinguish between the different preterm infant sleep states, among which polysomnography (PSG) is the most frequently used. However, this method is limited by the use of adhesive electrodes or patches that are attached to the body by numerous cables that can disturb sleep. Given the importance of sleep, this review explores more unobtrusive methods that can identify sleep states without disturbing the infant. To this end, after a brief introduction to preterm sleep states, an analysis of the physiological characteristics associated with the different sleep states is provided and various methods of measuring these physiological characteristics are explored. Finally, the advantages and disadvantages of each of these methods are evaluated and recommendations for neonatal sleep monitoring proposed.
Department of Electrical Engineering, University of Technology Eindhoven, De Zaale, 5612 AJ Eindhoven, The Netherlands; Philips Research, High Tech Campus 34, 5656 AE Eindhoven, The Netherlands. Electronic address: jan.werth@philips.com.
Jan
J
Werth
Philips Research, High Tech Campus 34, 5656 AE Eindhoven, The Netherlands.
Louis
L
Atallah
Neonatal Intensive Care Unit, Maxima Medical Center, De Run 4600, 5504 DB Veldhoven, The Netherlands; Faculty of Health, Medicine, and Life Science, Maastricht University, Minderbroedersberg 4-6, 6211 LK Maastricht, The Netherlands.
Peter
P
Andriessen
Department of Electrical Engineering, University of Technology Eindhoven, De Zaale, 5612 AJ Eindhoven, The Netherlands; Philips Research, High Tech Campus 34, 5656 AE Eindhoven, The Netherlands. Electronic address: xi.long@philips.com.
Xi
X
Long
Philips Research, High Tech Campus 34, 5656 AE Eindhoven, The Netherlands.
Elly
E
Zwartkruis-Pelgrim
Department of Electrical Engineering, University of Technology Eindhoven, De Zaale, 5612 AJ Eindhoven, The Netherlands; Philips Research, High Tech Campus 34, 5656 AE Eindhoven, The Netherlands.
Ronald M
RM
Aarts
D004569:Electroencephalography; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature / Q000502:physiology*; D017286:Polysomnography; D012890:Sleep / Q000502:physiology*; D012894:Sleep Stages / Q000502:physiology*
Active sleep; Contactless vital sign measurement; Preterm infant sleep; Quiet sleep; Sleep monitoring; Unobtrusive sleep measurement