The feasibility of actigraphy and care journals to examine sleep-wake patterns of preterm infants in the NICU

Abstract

Problem: Sleep disruption in preterm infants can have negative short- and long-term effects, such as behavioral changes, poor emotional regulation, and poor verbal skills. Purpose: Assess the feasibility of using actigraphy and infant care journals to examine sleep-wake patterns and care activities of premature infants in the NICU. Methods: An observational study was done in a level IV NICU with clinically stable infants 28-32 weeks gestation at DOL 2-7. Sleep-wake patterns were examined using the Actiwatch 2 and care activities were assessed using an infant care journal over 84 hours continuously. Scoring rules for actigraph data were developed to determine rest intervals. Sleep variables collected included total sleep time, percent of sleep, and number of wake bouts during sleep period. Care activities were documented in journals, including length of activities and whether infants were asleep or awake prior to and after the activity. Actigraphy data was assess using the Actiware software and, along with care activity data, were analyzed using SPSS. Feasibility is assessed through acceptability, implementation, practicality, and limited efficacy. Results: Data were analyzed on 10 infants. Rest intervals were 155 minutes ±5.3 minutes on average with infants spending an average of 67.1% ± 11.1% asleep. Average daily total sleep time was 902.5 minutes ±158.6 minutes, or 64.3% (± 10.85%) and care clustered with routine care made up 75.5% of the documented care activities. Conclusions: The feasibility of using actigraphy to examine sleep-wake patterns was supported, despite subjectivity. Sleep data were similar to previous literature, though the this sample is of younger gestation. While the amount of activities were less than previous studies, with modifications to methodology, data collection could be improved.