Development of fetal and neonatal sleep and circadian rhythms☆

Abstract 

The origin of sleep and circadian rhythms development is found during the fetal period. Both quiet (NREM) and active (REM) sleep are distinguishable during the last 10 weeks of gestation. Comparable to fetuses, low risk preterm infants recorded at 30–40 weeks postconceptional age, had a similar development of sleep i.e. an increase in quiet sleep and a decrease in indeterminate sleep. A further development in sleep organization characterized by increased slow wave and spindle activity during quiet sleep and coupling with circadian rhythm takes place during the first 6 months of life in both term and preterm infants.

Circadian rhythm of fetal heart rate synchronized with maternal rest-activity, heart rate, cortisol, melatonin, and body temperature rhythms is present during the last 10 weeks of gestation. Although maternally influenced, circadian rhythm antenatally becomes ultradian at birth. Both preterm and term infants show a significant increase in circadian body temperature rhythm amplitude during the first 3 months of life.

Keywords: Sleep, circadian rhythm, brain development, fetus, neonate, preterm infant

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• f1 Correspondence should be addressed to: Majid Mirmiran, M.D., Ph.D., Department of Pediatrics, Division of Neonatal and Developmental Medicine, School of Medicine, Stanford University, 750 Welch Road, Suite 315, Palo Alto, CA 94304, USA. E-mail: mirmiran@stanford.edu