Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA.
Department of Pediatrics, University of Massachusetts Medical School, Worcester, Massachusetts, USA.
J Sleep Res. 2023 Apr;32(2):e13610. doi: 10.1111/jsr.13610. Epub 2022 Apr 22.
Premature infants often require prolonged hospitalisation in the neonatal intensive care unit (NICU) where they are exposed to adverse noise that may disrupt sleep and further compromise recovery and developmental outcomes. This single-session trial assessed the effects of a novel circumaural hearing protection device (DREAMIES®; NEATCAP Medical LLC) on sleep in 10 premature infants (mean 34.1 weeks GA) in a Level III NICU. Using polysomnography (PSG), the infant's sleep was compared between three interfeed periods throughout which DREAMIES® was ON or OFF. Each infant received the same condition order, OFF1-ON-OFF2. The PSG 30 s epochs were scored by a rater masked to the condition as Quiet Sleep, Active Sleep, Indeterminate Sleep, and Wake. There was a 14.1% increase in sleep from OFF1 to ON (p = 0.05) and an 18.4% decrease in sleep from ON to OFF2 (p = 0.02); an analogous inverse effect was observed for wake (χ = 5.03, p = 0.08). There was a main effect of DREAMIES on active sleep (χ = 7.4, p = 0.025) due to more active sleep for ON1 (46%) compared with OFF2 (32%; p = 0.074). No significant effect was observed for quiet sleep or indeterminate sleep. On average, the sound level was 51 dBA (range 36-113 dBA) and did not differ significantly among the three periods. The strongest relationship between the minute-by-minute maximum sound level and movement actigraphy was observed for the OFF1 condition (ρ0.301, p < 0.001). These findings suggest that DREAMIES® may augment sleep in premature infants by reducing acute episodes of adverse noise in the NICU.
早产儿通常需要在新生儿重症监护病房（NICU）长时间住院，在那里他们会接触到不良噪音，这可能会干扰睡眠，并进一步损害他们的恢复和发育结果。这项单次试验评估了一种新型环耳听力保护装置（DREAMIES®；NEATCAP Medical LLC）对 10 名早产儿（平均胎龄 34.1 周）在三级 NICU 睡眠的影响。使用多导睡眠图（PSG），在三个间歇喂养期间比较了 DREAMIES®开启和关闭时婴儿的睡眠情况。每个婴儿都接受相同的条件顺序，即 OFF1-ON-OFF2。PSG 的 30 秒时相由一名评分员进行评分，评分员对条件不知情，将其分为安静睡眠、活跃睡眠、不确定睡眠和觉醒。从 OFF1 到 ON 时睡眠增加了 14.1%（p=0.05），从 ON 到 OFF2 时睡眠减少了 18.4%（p=0.02）；类似地，觉醒也出现了相反的影响（χ ²=5.03，p=0.08）。DREAMIES 对活跃睡眠有主要影响（χ ²=7.4，p=0.025），因为与 OFF2（32%）相比，ON1（46%）的活跃睡眠时间更多（p=0.074）。安静睡眠或不确定睡眠没有观察到显著影响。平均而言，声音水平为 51dBA（范围 36-113dBA），在三个时期之间没有显著差异。在 OFF1 条件下，观察到每分钟最大声音水平与运动活动计之间的关系最强（ρ0.301，p<0.001）。这些发现表明，DREAMIES®通过减少 NICU 中不良噪音的急性发作，可能会增加早产儿的睡眠。
