title: Distal skin vasodilation promotes rapid sleep onset in preterm neonates.
abstract: Although sleep is of paramount importance for preterm neonates, care of the latter in a neonatal intensive care unit does not favour sleep. Given that several studies in adults have described a 'vegetative preparedness to sleep' (in which distal skin vasodilation before lights-out promotes rapid sleep onset), we looked at whether or not this process operates in preterm neonates. Sleep propensity was assessed in terms of the duration of a spontaneous episode of wakefulness (W). Skin temperatures at six body sites (the abdomen, pectoral region, eye, hand, thigh and foot) were measured (using infrared thermography) during nocturnal polysomnography in 29 9-day-old preterm neonates (postmenstrual age: 209 ± 9 days). We then determined whether the duration of the W episode depended upon the local skin temperatures measured at the start, during and end of the episode. The W episode was shorter when distal skin temperatures (thigh, hand and foot) and the pectoral temperature were higher at the end of the episode (i.e. at sleep onset). The relationship with the duration of the W episode was not significant for temperatures measured at the start of the W episode. We observed gradual distal vasodilation at the pectoral region, the thigh, hand and foot (i.e. affecting most of the body's skin surface) during W episodes. Our results constitute initial evidence to show that distal vasodilation may have a key role in facilitating sleep onset in very preterm neonates.
authors.affiliation: PériTox, Jules Verne University of Picardy, Amiens, France.|Médecine Néonatale et Réanimation Pédiatrique, Pôle Femme Couple Enfant, Amiens, France.
authors.forename: Lucile
authors.initials: L
authors.lastname: Barcat
authors.affiliation: PériTox, Jules Verne University of Picardy, Amiens, France.
authors.forename: Pauline
authors.initials: P
authors.lastname: Decima
authors.affiliation: PériTox, Jules Verne University of Picardy, Amiens, France.|Neurologie Pédiatrique, Pôle Femme Couple Enfant, Amiens, France.
authors.forename: Emilie
authors.initials: E
authors.lastname: Bodin
authors.affiliation: PériTox, Jules Verne University of Picardy, Amiens, France.
authors.forename: Stephane
authors.initials: S
authors.lastname: Delanaud
authors.affiliation: PériTox, Jules Verne University of Picardy, Amiens, France.
authors.forename: Erwan
authors.initials: E
authors.lastname: Stephan-Blanchard
authors.affiliation: PériTox, Jules Verne University of Picardy, Amiens, France.|Médecine Néonatale et Réanimation Pédiatrique, Pôle Femme Couple Enfant, Amiens, France.
authors.forename: Andre
authors.initials: A
authors.lastname: Leke
authors.affiliation: PériTox, Jules Verne University of Picardy, Amiens, France.
authors.forename: Jean-Pierre
authors.initials: JP
authors.lastname: Libert
authors.affiliation: PériTox, Jules Verne University of Picardy, Amiens, France.|Médecine Néonatale et Réanimation Pédiatrique, Pôle Femme Couple Enfant, Amiens, France.
authors.forename: Pierre
authors.initials: P
authors.lastname: Tourneux
authors.affiliation: PériTox, Jules Verne University of Picardy, Amiens, France.
authors.forename: Veronique
authors.identifier: 0000-0002-0684-0305
authors.initials: V
authors.lastname: Bach
mesh_terms: D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature / Q000502:physiology*; D008297:Male; D017286:Polysomnography; D012867:Skin / Q000098:blood supply*; D012881:Skin Temperature / Q000502:physiology*; D012890:Sleep / Q000502:physiology*; D013817:Thermography; D014664:Vasodilation; D014851:Wakefulness / Q000502:physiology
keywords: infant; thermoregulation; wakefulness episode