Neuroprotective Core Measure 4: Safeguarding Sleep — Its Value in Neuroprotection of the Newborn

Robert D. White, MD


NAINR. 2015;15(3):114-115. 

In This Article

Abstract and Introduction


Sleep is critical to brain health at any age, but especially for the high-risk newborn. Protecting it is a challenge in the NICU for many reasons — babies are almost always asleep, it is difficult to tell what stage of sleep they are in, and many sources of sleep disruption in the NICU are not entirely preventable. Sleep usually occurs as part of a circadian rhythm at other ages, but high-risk newborns do not exhibit circadian rhythmicity and the NICU environment is not conducive to developing one. Both structural and operational strategies to protect sleep and its beneficial effects on the brain are outlined. Increased parental interaction with the baby may be the best way to reduce noxious stimuli and provide nurturing stimuli while supporting sleep.


Sleep is one of medicine's most powerful allies. It is critical to brain health at every age. Sleep deprivation is especially hazardous to brain function when the individual is under stress, such as from illness. It is probably no coincidence that the normal amount of sleep per day during the lifespan is roughly proportionate to the velocity of brain growth and development; both are at their highest level in the earliest stages of infancy. From these observations, it should be evident that at no point in life is protecting sleep more important than in the high-risk preterm infant. In spite of this, few NICUs have the operational or technological capacity to observe or document sleep stages in their patients, resulting in inadvertent but frequent interruption of sleep in these highest-risk babies.