Medical Student Research Fellowship for Summer 2003

Mentor: Jeffrey Perlman
Department: Pediatrics
Room number: E-3-406
Mail Code: 9063
Phone number: 214-648-3903
E-mail: jeffrey.perlman@utsouthwestern.edu
Project title: Assessment of the impact of Music on Mevements and Heart Rate in Newborns

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 followup 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 noise 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 development in the recovering sick premature infant. Moreover we are evaluating factors that modify the patterns of sleep. Specifically we are evaluating the effect of music on sleep patterns
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 actinometer is used to measure movements for 48 hours ( there is strong correlation between movements and sleep states
4) For six hours on each of the two days a clinical assessment of sleep states is made. There are four
distinct sleep states i.e. awake and crying, quiet awake, rapid eye movement sleep(REM) and quiet
sleep. In addition, the premature infant has arousals which can arise from both REM and quiet sleep.
In addition to the sleep states measurements of heart rate and pulse oximetry are made 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 actographic 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.

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