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Sleep Structure and Scoring from Infancy to Adolescence

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Sleep Disorders in Children

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Abstract

From birth to adolescence, substantial changes occur in sleep temporal organization, percentage of stages, and electroencephalographic patterns. A well-developed circadian rhythm is evident after 3 months of age, subsequently enriched by the appearance of an adult ultradian sleep cycle, after 9 months of age. In newborns, the NREM/REM alternation is included in a “polycyclic” sleep-wake pattern, as opposed to the “monocyclic” pattern, typical of adulthood/adolescence. While newborns sleep for about 60 % of the day, with increasing age the amount of daytime sleep shows a reduction and nighttime sleep becomes more stable and continuous, becoming somewhat consolidated starting from 12 months of life, when it lasts on average 12 h/night vs. 10 h of a 3-month-old baby. Sleep spindles appear as early as 4 weeks but are present in all subjects after 8 weeks of age; in infants and children, they are generally bilateral but asynchronous. K-complexes are well defined at 6 months of age, being most evident in the frontal areas. K-complex maturation progresses rapidly for the first 2 years of life. Slow-wave activity, the major feature of sleep, appears around 2 months of age, and its amplitude increases abruptly during the first years of life, peaking in childhood, and then declining across adolescence. After the manual developed by Anders et al. in 1971 for sleep scoring from birth to 4 months of age, the American Academy of Sleep Medicine more recently provided two sets of rules: one for scoring sleep in infants (<2 months) and another for scoring sleep in children. Finally, sleep microstructure can be assessed by the analysis of the cyclic alternating pattern (CAP) also in children; CAP rate shows a clear increasing trend with age, but the distribution of the different A subtypes (slow and fast) undergoes complex and different changes.

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Authors and Affiliations

  1. Department of Neurology I.C, Sleep Research Centre, Oasi Institute for Research on Mental Retardation and Brain Aging (IRCCS), via C. Ruggero 73, 94018, Troina, Italy

    Raffaele Ferri MD

  2. Department of Developmental Neurology and Psychiatry, Center for Pediatric Sleep Disorders, Sapienza University, Rome, Italy

    Luana Novelli PsyD

  3. Department of Developmental and Social Psychology, S. Andrea Hospital, Sapienza University, Rome, Italy

    Oliviero Bruni MD

Authors
  1. Raffaele Ferri MD
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  2. Luana Novelli PsyD
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  3. Oliviero Bruni MD
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Correspondence to Raffaele Ferri MD .

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Editors and Affiliations

  1. Department of Neurology, Charles University and General Teaching Hospital, Prague, Czech Republic

    Soňa Nevšímalová

  2. Sapienza University, S. Andrea Hospital, Department of Developmental and Social Psychology, Rome, Roma, Italy

    Oliviero Bruni

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Ferri, R., Novelli, L., Bruni, O. (2017). Sleep Structure and Scoring from Infancy to Adolescence. In: Nevšímalová, S., Bruni, O. (eds) Sleep Disorders in Children. Springer, Cham. https://doi.org/10.1007/978-3-319-28640-2_6

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  • DOI: https://doi.org/10.1007/978-3-319-28640-2_6

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-28638-9

  • Online ISBN: 978-3-319-28640-2

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