Sleep Organization in Premature Infants With Feeding Difficulties
27 janvier 2020 mis à jour par: Children's Hospital Medical Center, Cincinnati
Babies born too soon, premature babies, can have complications following birth because their systems are immature.
Hospitals help prevent deformities and delays in motor development by using therapeutic positioning to provide containment as they would experience in the womb.
They also often have trouble eating.
They have discomfort, are irritable, refuse to eat and cry because their digestive system is immature.
The neonatal intensive unit can create stress and disrupt their sleep.
Going from active to deep sleep is essential for infant brain development, learning and memory formation.
Their sleep states early in life predict their developmental outcome.
The purpose is to determine whether a conformational positioning system, one that can mold to the baby and contain him or her, will allow more time asleep in premature infants with feeding problems compared to the standard crib mattress.
We hypothesize that the number of total sleep time will be longer and the number of arousals out of sleep lower when they are sleeping on the conformational positioning system compared to the mattress.
Aperçu de l'étude
Statut
Complété
Les conditions
Intervention / Traitement
Description détaillée
Premature infants are at risk for complications due to the immaturity of motor, gastrointestinal, respiratory, cutaneous and behavioral systems.
Therapeutic positioning is routinely used to provide containment, maintain a flexed position and prevent skeletal deformities and delays in motor development.
Premature infants have feeding difficulties and frequently experience gastroesophageal reflux, discomfort, refusal to feed, irritability, and crying.
The neonatal intensive care environment can create stress and disrupts sleep-wake cycles and self-regulatory behaviors.
Cycling from active to deep sleep states is required for neurosensory processing, learning, memory formation and brain plasticity.
Sleep and waking states for premature infants are predictive of neurodevelopmental outcomes.
The purpose of the study is to determine whether the use of conformational positioning will be associated with greater total sleep time in premature infants with a history feeding difficulty compared to positioning on a mattress alone.
We hypothesize that the number of arousals and total sleep time will be affected by the support surface.
Specifically, the number of arousals will be lower and total sleep time will be greater for infants when they are on a conformational positioning (CP) device compared to when they are on the standard positioning system (mattress) (SP).
The use of CP will reduce the number of arousals, increase the total sleep time, and bring about behavioral states that are conducive to regulation of attention, state and motor response relative to SP.
Type d'étude
Interventionnel
Inscription (Réel)
25
Phase
- N'est pas applicable
Contacts et emplacements
Cette section fournit les coordonnées de ceux qui mènent l'étude et des informations sur le lieu où cette étude est menée.
Lieux d'étude
-
-
Ohio
-
Cincinnati, Ohio, États-Unis, 45229
- Cincinnati Children's Hospital Medical Center
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Critères de participation
Les chercheurs recherchent des personnes qui correspondent à une certaine description, appelée critères d'éligibilité. Certains exemples de ces critères sont l'état de santé général d'une personne ou des traitements antérieurs.
Critère d'éligibilité
Âges éligibles pour étudier
6 mois à 8 mois (Enfant)
Accepte les volontaires sains
Non
Sexes éligibles pour l'étude
Tout
La description
Inclusion Criteria:
- Gestational age of < 37 weeks
- Feeding difficulty due to prematurity or a medical condition
- Not taking sedative medications for 24 hours before sleep study
- Post-surgery
- Sufficiently medically stable to undergo procedures
Exclusion Criteria:
- Gestational age equal to or greater than 37 weeks
- Clinical apnea
- Require mechanical ventilatory support
- Received sedative medications 24 hours before sleep study
- Brain injury or neurological condition that limits movement
- Orthopedic conditions requiring fixed positioning
- Arthrogryposis
- Osteogenesis imperfecta
- Medically unstable such that procedures cannot be tolerated
Plan d'étude
Cette section fournit des détails sur le plan d'étude, y compris la façon dont l'étude est conçue et ce que l'étude mesure.
Comment l'étude est-elle conçue ?
Détails de conception
- Objectif principal: Traitement
- Répartition: N / A
- Modèle interventionnel: Affectation à un seul groupe
- Masquage: Seul
Armes et Interventions
Groupe de participants / Bras |
Intervention / Traitement |
|---|---|
|
Expérimental: conformational positioner & mattress
conformational positioner & mattress, five hours on each
|
The conformational positioning system will be compared to the standard infant crib mattress.
Autres noms:
|
Que mesure l'étude ?
Principaux critères de jugement
Mesure des résultats |
Description de la mesure |
Délai |
|---|---|---|
|
Sleep organization defined as efficiency, active sleep time, quiet sleep time, number of arousals, measured by polysomnography
Délai: Overnight, 10.5 hour standard EEG sleep study
|
Standard polysomnography electrodes are applied to the subject in the evening and the subject is placed on either the standard mattress or the conformational positioning system (assigned at random) for the first 5 hours.
The subject is then moved onto the second treatment for the remainder of the study.
EEG measures are recorded continuously over the entire period.
The EEG data are assessed by trained sleep study physicians and clinical staff.
|
Overnight, 10.5 hour standard EEG sleep study
|
Mesures de résultats secondaires
Mesure des résultats |
Description de la mesure |
Délai |
|---|---|---|
|
Sleep state by behavioral observation
Délai: Two 30-minute periods, one on each treatment, during the EEG sleep study
|
Nurses trained in the techniques of premature infant behavioral state determination will observe the infant for two 30-minute periods while the EEG sleep study is being conducted.
One nurse will observe when the subject is on the standard mattress and the other will observe when the subject is on the conformational positioning system.
They will record specific behaviors observed in 2-minute intervals during the 30-minute period.
|
Two 30-minute periods, one on each treatment, during the EEG sleep study
|
Autres mesures de résultats
Mesure des résultats |
Description de la mesure |
Délai |
|---|---|---|
|
Impact of prior surgery on sleep organization
Délai: Overnight, 10-hour sleep study
|
Standard polysomnography electrodes are applied to the subject in the evening and the subject is placed on either the standard mattress or the conformational positioning system (assigned at random) for the first 5 hours.
The subject is then moved onto the second treatment for the remainder of the study.
EEG measures are recorded continuously over the entire period.
The EEG data are assessed by trained sleep study physicians and clinical staff.
The sleep organization and behaviorally observed sleep state will be compared for the subjects grouped as having had surgery prior to the study or not having had surgery to ascertain the impact of surgery while controlling for the treatment effects.
|
Overnight, 10-hour sleep study
|
Collaborateurs et enquêteurs
C'est ici que vous trouverez les personnes et les organisations impliquées dans cette étude.
Les enquêteurs
- Chercheur principal: Marty O Visscher, PhD, Children's Hospital Medical Center, Cincinnati
Publications et liens utiles
La personne responsable de la saisie des informations sur l'étude fournit volontairement ces publications. Il peut s'agir de tout ce qui concerne l'étude.
Dates d'enregistrement des études
Ces dates suivent la progression des dossiers d'étude et des soumissions de résultats sommaires à ClinicalTrials.gov. Les dossiers d'étude et les résultats rapportés sont examinés par la Bibliothèque nationale de médecine (NLM) pour s'assurer qu'ils répondent à des normes de contrôle de qualité spécifiques avant d'être publiés sur le site Web public.
Dates principales de l'étude
Début de l'étude
1 septembre 2011
Achèvement primaire (Réel)
1 juillet 2012
Achèvement de l'étude (Réel)
1 juillet 2012
Dates d'inscription aux études
Première soumission
17 septembre 2013
Première soumission répondant aux critères de contrôle qualité
18 septembre 2013
Première publication (Estimation)
19 septembre 2013
Mises à jour des dossiers d'étude
Dernière mise à jour publiée (Réel)
29 janvier 2020
Dernière mise à jour soumise répondant aux critères de contrôle qualité
27 janvier 2020
Dernière vérification
1 septembre 2013
Plus d'information
Termes liés à cette étude
Mots clés
Termes MeSH pertinents supplémentaires
Autres numéros d'identification d'étude
- CHMC 2011-1456
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