Request for Funding

Medical Student Research Fellowship for Summer 2002

Mentor: Jeffrey Perlman
Department: Pediatrics
Room number: E3-406
Mail Code: 9063
Phone number: 8-2060
E-mail: jeffrey.perlman@utsouthwestern.edu
Project title: Assessment of Music on Sleep States in Newborn Infants

Human subjects IRB approved project number (where applicable): 0101-044

Animal subjects IRB approved project number (where applicable):

Project Type (patient-based research, animal-based research, or basic research; this characterization is only to permit a general classification for grouping similar types of projects) Patient based

Brief Description of Project:

Cognitive and behavioral deficits affect up to 50% of very low birthweight premature infants at long term follow up that has extended into school age and adolescence. Numerous medical and environmental factors may contribute to these problems. Of particular interest is the role of the stressful neonatal environment as it contributes to these deficits. Thus the premature infant is often subjected to prolonged hospitalization with multiple constraints, constant bright light and frequent loud noise. We have structurally modified our intensive care environment to provide alternating lighting with the capacity to provide a more appropriate day night cycling pattern, reduce noised levels and displaced the sound with background music.
In order to begin to assess the impact of these changes on development we have embarked on a long-term project to study the ontogeny of sleep states in the recovering sick premature infant. Moreover we are evaluating factors that modify the patterns of sleep states. Specifically we are evaluating the effect of music on sleep states.
Methods
1) Premature infants < 1000g birthweight or < 28 weeks gestational age are studied when they reach 28
weeks post conceptual age (prior to this time, it is difficult to distinguish the different sleep states (see
below), and who are not requiring respiratory support
2) Each infant is studied for 48 hours each week until discharge (usually for a total of 6 weeks)
3) An actimeter is placed on the foot of the infant and is used to measure movements-this is done for 48 hours ( there is strong correlation between movements and sleep states). (the investigator is not present for the 48 hours)
4) For six hours on the first day, a clinical assessment of sleep states is made. The premature infant exhibits four
distinct sleep states i.e. awake and crying, quiet awake, rapid eye movement sleep(REM) and quiet
sleep. In addition, the premature infant exhibits "arousals" which can arise from both REM and quiet sleep. Early
In addition to the sleep states. measurements of heart rate and pulse oximetry are recorded from monitors
already in place as part of clinical management of the infant.
5) The infants are subjected to a protocol of alternating music versus a silent period over the six hours.
The duration of music is one hour followed by a silent period of one hour, followed by a period of music. The infant is then fed. This is followed by one hour of silence and then one hour of music and then silence. The following day the order is reversed. The music is that of Mozart.
6) The actimeter measurements are downloaded and the data subsequently analysed

Preliminary observations
1) There is a marked effect of sleep position on sleep states
2) There is progressive development of quiet sleep as a function of postconceptual age
3) The effect of music on sleep states remains unclear

I anticipate that over a three month period, approximately 10 premature infants will be studied.

Previous Research Activities or Publications with Medical Students:
None

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