Thoman E B, Korner A F, Kraemer H C
Dev Psychobiol. 1976 May;9(3):271-83. doi: 10.1002/dev.420090311.
In this study we identified consistent characteristics of the sleep-wake state of newborn infants. Forty-one normal, full-term infants were observed in a warmer-skin temperature maintained at 36.1 degree C--located in a sound-attenuated room for 1 hr during 2 successive mid-feeding periods. The infant's state was recorded on a check-list every 10 sec using the following categories for sleep and wakefulness: Quiet Sleep A, Quiet Sleep B, Active Sleep Without REM, Active Sleep With REM, Active Sleep With Dense REM, Drowsy, Alert Inactivity, WAKING Activity, Fussing, Crying, and Indefinite State. Immediately following the completion of each observation, the 2 observers made independent judgments of the degree of organization shown by the infant, using a 6-point scale. Over the two 1-hr observations, only Quiet Sleep A, Quiet Sleep B, and Crying showed any consistency. Active Sleep as typically defined showed no consistency whatsoever. However, 2 of the 3 components of Active Sleep were significantly reliability measures for the 2 observations; in sleeping infants all 3 components of active sleep showed high reliability. These results indicate that Active Sleep may be a composite of at least 3 meaningful categories. To look at overall state organization in the neonate, including both sleep and wake states, we considered Active Sleep as 3 separate states and then combined the resulting 11 behavioral states into derived clusters such that each combination of states showed a test-retest reliability above .52. With these 5 state clusters we viewed each infant's state behaviors in terms of a profile depicting the percent of time spent in each state cluster. We found a close association between these profiles and the subjective judgments of sleep-wake state organization made by the observers. The results clearly indicate that a 1-hr observation provides reliable information on individual sleep-wake states in the newborn.
在本研究中，我们确定了新生儿睡眠-觉醒状态的一致特征。41名正常足月婴儿在皮肤温度保持在36.1摄氏度的暖箱中观察，暖箱位于隔音室内，在连续两个喂奶中期各观察1小时。每隔10秒使用以下睡眠和觉醒类别在检查表上记录婴儿的状态：安静睡眠A、安静睡眠B、无快速眼动的主动睡眠、有快速眼动的主动睡眠、有密集快速眼动的主动睡眠、困倦、警觉不动、觉醒活动、烦躁、哭泣和不确定状态。每次观察结束后，两名观察者立即使用6分制对婴儿表现出的组织程度进行独立判断。在两次1小时的观察中，只有安静睡眠A、安静睡眠B和哭泣表现出任何一致性。通常定义的主动睡眠没有任何一致性。然而，主动睡眠的三个组成部分中的两个在两次观察中是显著可靠的指标；在睡眠婴儿中，主动睡眠的所有三个组成部分都表现出高可靠性。这些结果表明，主动睡眠可能是至少三个有意义类别的组合。为了观察新生儿的整体状态组织，包括睡眠和觉醒状态，我们将主动睡眠视为三个独立的状态，然后将由此产生的11种行为状态组合成派生集群，使得每种状态组合的重测信度高于0.52。通过这五个状态集群，我们根据描述每个状态集群所花费时间百分比的概况来观察每个婴儿的状态行为。我们发现这些概况与观察者对睡眠-觉醒状态组织的主观判断之间存在密切关联。结果清楚地表明，1小时的观察为新生儿个体的睡眠-觉醒状态提供了可靠信息。
