Hübler Axel
Hospital for Children and Adolescents, Klinikum Chemnitz, 09116 Chemnitz, Germany.
Children (Basel). 2025 Jun 16;12(6):781. doi: 10.3390/children12060781.
The development of a normal sleep-wake rhythm in the first weeks of life depends on the physiological sensory needs of the newborn as well as the environment surrounding them. This includes, for example, avoiding pain, exposure to bright light at night and high noise levels. In high-risk newborns, this process can be influenced by immaturity of the central and peripheral nervous systems, therapeutic strategies and the work organization of an intensive care unit.
This study used a narrative review to examine the literature on the interrelationship of sensory modalities on sleep-wake behavior in the context of neonatal intensive care. The current Cochrane reviews on cycled lighting's effect on premature infants' circadian rhythm development and noise or sound management in the neonatal intensive care unit, as well as the World Health Organization (WHO) global position paper on kangaroo mother care, were included.
An extensive body of literature relates to fetal and neonatal development of the five sensory modalities: touch, taste, smell, hearing and sight. In contrast, there is a lack of evidence regarding the choice of optimal lighting and suitable measures for noise reduction. Since 2023, the WHO has recommended that, from the moment of birth, every "small and sick" newborn should remain in skin-to-skin contact (SSC) with their mother. Developmental support pursues a multimodal approach with the goal of fostering early parent-child bonding, including the child's needs and environmental conditions.
The implementation of early SSC and attention to the sleep-wake cycle require systemic changes in both the obstetric and neonatal settings to ensure seamless perinatal management and subsequent neonatal intensive care. Since there is a lack of evidence on the optimal sensory environment, well-designed, well-conducted and fully reported randomized controlled trials are needed that analyze short-term effects and long-term neurodevelopmental outcomes.
新生儿出生后最初几周正常睡眠-觉醒节律的形成取决于新生儿的生理感官需求及其周围环境。这包括，例如，避免疼痛、夜间暴露于强光和高噪音水平。在高危新生儿中，这一过程会受到中枢和外周神经系统不成熟、治疗策略以及重症监护病房的工作安排的影响。
本研究采用叙述性综述，考察新生儿重症监护背景下感觉模态与睡眠-觉醒行为之间相互关系的文献。纳入了Cochrane系统评价中关于循环光照对早产儿昼夜节律发育的影响以及新生儿重症监护病房噪音或声音管理的内容，以及世界卫生组织（WHO）关于袋鼠式护理法的全球立场文件。
大量文献涉及五种感觉模态（触觉、味觉、嗅觉、听觉和视觉）的胎儿及新生儿发育情况。相比之下，关于最佳光照选择和合适降噪措施的证据不足。自2023年以来，WHO建议从出生起，每个“体弱患病”的新生儿都应与母亲保持皮肤接触（SSC）。发育支持采用多模态方法，目标是促进早期亲子关系，包括孩子的需求和环境条件。
实施早期SSC并关注睡眠-觉醒周期需要产科和新生儿科室进行系统性变革，以确保围产期管理及后续新生儿重症监护的无缝衔接。鉴于缺乏关于最佳感官环境的证据，需要开展设计良好、实施得当且报告完整的随机对照试验，分析短期效果和长期神经发育结局。
