ABSTRACT
PURPOSE: To evaluate the frequency of preterm infant positions during sleep, and to investigate the association among positions, arousals, sleep patterns, and time of day. DESIGN AND METHODS: This observational study was conducted in a neonatal unit with 10 preterm infants. Polysomnographic and video recordings during 24 hr identified sleep positions, arousals, sleep patterns, and time of day. RESULTS: Preterm infants were placed most frequently in the supine position (58.4%), followed by right side (24.9%), left side (15.5%), and prone (1.2%). The longest amount of time spent sleeping, and the most frequent number of arousals, occurred in the supine position, followed by prone, left-side, and right-side positions. After controlling for length of time spent in each position, the number of arousals per hour was the greatest in the supine position (13.562 ± 0.732) and least in the prone position (11.56 ± 4.754; p < .001). There were no significant differences in arousals according to position and sleep pattern (indeterminate, quiet, active sleep) or position and time of day (morning, afternoon, twilight, night). PRACTICE IMPLICATIONS: Nurses should evaluate the frequency of preterm infant arousals in each position, and use more often those positions that lead to a lower frequency of arousals and better sleep quality.
Subject(s)
Arousal/physiology , Infant, Premature/physiology , Neonatal Nursing/methods , Prone Position/physiology , Sleep/physiology , Supine Position/physiology , Bedding and Linens , Female , Humans , Infant Care/methods , Infant, Newborn , MaleABSTRACT
Este estudo teve como objetivo verificar a influência da posição de dormir no sono da criança. Uma revisão integrativa foi conduzida nas bases de dados Pubmed, LILACS, SciELO e Cochrane, com os descritores "sleep", "infant" e as expressões "position" e "positioning", nos idiomas espanhol, inglês e português, publicadas entre 2000 e 2013. Seis artigos que atenderam aos critérios de inclusão e exclusão foram identificados. Os estudos foram categorizados em despertares e estágios de sono. Os resultados indicaram que a criança na posição prona apresenta menor quantidade de despertares, possibilitando sono ativo mais profundo e maior quantidade de sono quieto. A posição supina está relacionada à maior quantidade de sono ativo e mais despertares e não expõe a criança ao risco da síndrome da morte súbita infantil. Concluiu-se que a posição supina possibilita mais despertares que a prona, entretanto, promove mais segurança da criança durante o sono.
This study aimed to verify the influence of infant sleeping position on sleep. An integrative literature review was conducted in Pubmed, LILACS, SciELO and Cochrane, with the descriptors, "sleep', "infant' and the terms "position' and "positioning", in Spanish, English and Portuguese, published between 2000 and 2013. Six articles met the criteria for inclusion and exclusion. These studies were categorized into arousal from sleep and sleep stages. The results indicated that in the prone position, the infant had fewer arousal events, enabling deeper active sleep and greater amount of quiet sleep. The supine position is related to a greater amount of active sleep and more arousals, and does not expose the infant to the risk of Sudden Infant Death Syndrome. The supine position results in more arousals than the prone position, however, it promotes greater safety to the infant during sleep.
El objetivo de este estudio fue verificar la influencia de la posición de dormir sobre el sueno del nino. Se realizó una revisión integradora en las bibliotecas PubMed, LILACS, SciELO y Cochrane con los descriptores sleep, infant y las expresiones position y positioning, en espanol, inglés y português, publicados entre 2000y 2013. Fueron identificados seis artículos que atendían los criterios de inclusión. Los estudiosfueron clasficados en despertares y etapas del sueno. Los resultados indicaron que el nino en la posición prona presenta menor cantidad de despertares, lo cual permite un sueno activo más profundo y una mayor cantidad de sueno tranquilo. La posición supina se relaciona con una mayor cantidad de sueno activo y de despertares y no expone al nino al riesgo del síndrome de muerte súbita del lactante. Se llegó a la conclusión que en la posición supina hay más despertares que en la prona pero que, sin embargo, durante el sueno, esa posición es más segura para el nino.