Department of Paediatrics, University of Cambridge, Cambridge Biomedical Campus, Cambridge, UK.
BABA Center, Pediatric Research Center, Department of Clinical Neurophysiology, Children's Hospital, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.
Pediatr Res. 2022 Mar;91(4):771-786. doi: 10.1038/s41390-021-01497-4. Epub 2021 Apr 15.
The proper development of sleep and sleep-wake rhythms during early neonatal life is crucial to lifelong neurological well-being. Recent data suggests that infants who have poor quality sleep demonstrate a risk for impaired neurocognitive outcomes. Sleep ontogenesis is a complex process, whereby alternations between rudimentary brain states-active vs. wake and active sleep vs. quiet sleep-mature during the last trimester of pregnancy. If the infant is born preterm, much of this process occurs in the neonatal intensive care unit, where environmental conditions might interfere with sleep. Functional brain connectivity (FC), which reflects the brain's ability to process and integrate information, may become impaired, with ensuing risks of compromised neurodevelopment. However, the specific mechanisms linking sleep ontogenesis to the emergence of FC are poorly understood and have received little investigation, mainly due to the challenges of studying causal links between developmental phenomena and assessing FC in newborn infants. Recent advancements in infant neuromonitoring and neuroimaging strategies will allow for the design of interventions to improve infant sleep quality and quantity. This review discusses how sleep and FC develop in early life, the dynamic relationship between sleep, preterm birth, and FC, and the challenges associated with understanding these processes. IMPACT: Sleep in early life is essential for proper functional brain development, which is essential for the brain to integrate and process information. This process may be impaired in infants born preterm. The connection between preterm birth, early development of brain functional connectivity, and sleep is poorly understood. This review discusses how sleep and brain functional connectivity develop in early life, how these processes might become impaired, and the challenges associated with understanding these processes. Potential solutions to these challenges are presented to provide direction for future research.
新生儿生命早期睡眠和睡眠-觉醒节律的正常发育对终生神经健康至关重要。最近的数据表明，睡眠质量差的婴儿存在神经认知功能受损的风险。睡眠发生是一个复杂的过程，在此过程中，在妊娠最后三个月期间，大脑状态从活跃（清醒）到活跃睡眠（快速眼动睡眠）再到安静睡眠（非快速眼动睡眠）之间交替。如果婴儿早产，这个过程的大部分都发生在新生儿重症监护病房，在那里环境条件可能会干扰睡眠。功能脑连接（FC），反映大脑处理和整合信息的能力，可能会受损，随之而来的是神经发育受损的风险。然而，将睡眠发生与 FC 的出现联系起来的具体机制尚不清楚，也很少有研究，主要是因为研究发展现象之间的因果关系以及评估新生儿 FC 具有挑战性。最近在婴儿神经监测和神经影像学策略方面的进展将允许设计干预措施来改善婴儿的睡眠质量和数量。这篇综述讨论了睡眠和 FC 在生命早期的发展方式、睡眠、早产和 FC 之间的动态关系，以及理解这些过程所面临的挑战。影响：生命早期的睡眠对于适当的大脑功能发育至关重要，这对于大脑整合和处理信息至关重要。早产儿的这个过程可能会受损。早产、大脑功能连通性的早期发育和睡眠之间的联系尚未得到充分理解。这篇综述讨论了睡眠和大脑功能连通性在生命早期的发展方式、这些过程可能受损的方式，以及理解这些过程所面临的挑战。为了为未来的研究提供方向，提出了应对这些挑战的潜在解决方案。
