title: Discrimination of sleep states using continuous cerebral bedside monitoring (amplitude-integrated electroencephalography) compared to polysomnography in infants.
abstract: OBJECTIVE
  Limited two-channel electroencephalography (EEG) and amplitude-integrated EEG (aEEG) monitorings are being increasingly used; however, these measurements have not been compared with polysomnographic monitoring, the gold standard for determining infant sleep states. We aimed to determine the accuracy of two-channel EEG and aEEG recordings in defining sleep states and wakefulness in term infants compared to polysomnographic monitoring.
  
  
  METHODS
  Sleep was assessed in eight healthy term born infants (mean: 34 ± 3 days), using simultaneous polysomnography (Compumedics S-Series) and a two-channel EEG monitor (Brainz BRM2). EEG intensity, 90% spectral edge frequency (SEF), aEEG amplitude frequency bands were analysed in 30-second epochs during quiet sleep, active sleep and awake as determined by polysomnography.
  
  
  RESULTS
  BRM2-recorded EEG accurately identified quiet sleep from active sleep for EEG intensity (p = 0.003), SEF (p = 0.001) and aEEG amplitude (p = 0.003) and quiet sleep from awake, but not active sleep from awake. Frequency band analysis showed that wake could be identified by changes in absolute power (p = 0.015) and frequency as a percentage of total power (p = 0.03).
  
  
  CONCLUSIONS
  We demonstrate that limited two-channel EEG monitoring can distinguish quiet sleep from active sleep and may be suitable for investigating the development of sleep in infants in the neonatal intensive care setting.
authors.affiliation: Department of Physiology, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand.
authors.forename: Laura
authors.initials: L
authors.lastname: Bennet
authors.affiliation: The Ritchie Centre, Hudson Institute of Medical Research, Melbourne, Victoria, Australia.|The Department of Paediatrics, Monash University, Melbourne, Victoria, Australia.
authors.forename: Karinna L
authors.initials: KL
authors.lastname: Fyfe
authors.affiliation: The Ritchie Centre, Hudson Institute of Medical Research, Melbourne, Victoria, Australia.|The Department of Paediatrics, Monash University, Melbourne, Victoria, Australia.
authors.forename: Stephanie R
authors.initials: SR
authors.lastname: Yiallourou
authors.affiliation: The Ritchie Centre, Hudson Institute of Medical Research, Melbourne, Victoria, Australia.
authors.forename: Henriette
authors.initials: H
authors.lastname: Merk
authors.affiliation: The Ritchie Centre, Hudson Institute of Medical Research, Melbourne, Victoria, Australia.|The Department of Paediatrics, Monash University, Melbourne, Victoria, Australia.
authors.forename: Flora Y
authors.initials: FY
authors.lastname: Wong
authors.affiliation: The Ritchie Centre, Hudson Institute of Medical Research, Melbourne, Victoria, Australia.|The Department of Paediatrics, Monash University, Melbourne, Victoria, Australia.
authors.forename: Rosemary S C
authors.initials: RS
authors.lastname: Horne
mesh_terms: D004569:Electroencephalography; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D017286:Polysomnography; D012890:Sleep
keywords: Brain development; Polysomnography; Preterm infants; Sleep states