Sleep Organization in Premature Infants With Feeding Difficulties
Condition: Premature Infant Sleep
MeSH terms: Premature Birth
Study type: Interventional

Summary: 
      Babies born too soon, premature babies, can have complications following birth because their
      systems are immature. Hospitals help prevent deformities and delays in motor development by
      using therapeutic positioning to provide containment as they would experience in the womb.
      They also often have trouble eating. They have discomfort, are irritable, refuse to eat and
      cry because their digestive system is immature. The neonatal intensive unit can create stress
      and disrupt their sleep. Going from active to deep sleep is essential for infant brain
      development, learning and memory formation. Their sleep states early in life predict their
      developmental outcome. The purpose is to determine whether a conformational positioning
      system, one that can mold to the baby and contain him or her, will allow more time asleep in
      premature infants with feeding problems compared to the standard crib mattress. We
      hypothesize that the number of total sleep time will be longer and the number of arousals out
      of sleep lower when they are sleeping on the conformational positioning system compared to
      the mattress.
    

Detailed description: 
      Premature infants are at risk for complications due to the immaturity of motor,
      gastrointestinal, respiratory, cutaneous and behavioral systems. Therapeutic positioning is
      routinely used to provide containment, maintain a flexed position and prevent skeletal
      deformities and delays in motor development. Premature infants have feeding difficulties and
      frequently experience gastroesophageal reflux, discomfort, refusal to feed, irritability, and
      crying. The neonatal intensive care environment can create stress and disrupts sleep-wake
      cycles and self-regulatory behaviors. Cycling from active to deep sleep states is required
      for neurosensory processing, learning, memory formation and brain plasticity. Sleep and
      waking states for premature infants are predictive of neurodevelopmental outcomes. The
      purpose of the study is to determine whether the use of conformational positioning will be
      associated with greater total sleep time in premature infants with a history feeding
      difficulty compared to positioning on a mattress alone. We hypothesize that the number of
      arousals and total sleep time will be affected by the support surface. Specifically, the
      number of arousals will be lower and total sleep time will be greater for infants when they
      are on a conformational positioning (CP) device compared to when they are on the standard
      positioning system (mattress) (SP). The use of CP will reduce the number of arousals,
      increase the total sleep time, and bring about behavioral states that are conducive to
      regulation of attention, state and motor response relative to SP.
    

Intervention name(s): Conformational positioning system
Intervention type(s): Other
Intervention description(s): The conformational positioning system will be compared to the standard infant crib mattress.
Other intervention name(s): therapeutic positioner; fluidized bed positioner
Intervention model: Single Group Assignment
Masking: Single (Outcomes Assessor)
Primary purpose: Treatment
Keywords: sleep; sleep efficiency; active sleep; quiet sleep; arousals; premature infant; conformational positioning; mattress; feeding difficulty; neonatal intensive care unit; sleep state; behavioral observation; stress behavior; self-regulatory behavior; surgery; gastrointestinal