Elsevier

Sleep Medicine Clinics

Volume 2, Issue 3, September 2007, Pages 321-329
Sleep Medicine Clinics

Sleep Behavior and Sleep Regulation from Infancy through Adolescence: Normative Aspects

https://doi.org/10.1016/j.jsmc.2007.05.001Get rights and content

Knowledge of what constitutes normal sleep behavior during development is a prerequisite for understanding sleep disorders in children and adolescents. This article describes normal sleep patterns in children and adolescents, depicts sleep stages and sleep electrophysiology, and identifies changes in sleep-wake (homeostatic) and circadian regulatory processes across early human development. Two basic principles guide the consideration of normal sleep during childhood: sleep patterns exhibit large variability among children, and sleep behavior must be viewed within a biopsychosocial framework.

Section snippets

Newborn period and infancy

Sleep of newborns is distributed equally across day and night (Fig. 1). In the first few months of life, however, infants gain the ability to sustain longer episodes of sleep and waking [5], [6], as sleep becomes more and more consolidating toward the nighttime, nocturnal sleep duration increases, and daytime sleep declines (Fig. 2) [7]. Although consolidated nocturnal episodes of sleep generally do not occur before 6 weeks of age, day-night differences in rest-activity behavior may be observed

Sleep stages and sleep electrophysiology during development

Two distinct sleep states are defined on the basis of polysomnography that monitors electroencephalographic (EEG) patterns, eye movements, and muscle tone: rapid eye movement sleep (REMS) and non-REMS (NREMS). In the first 6 months after birth, REMS is called “active sleep,” whereas NREMS is termed “quiet sleep.” In newborns, quiet and active sleep is often disorganized and immature (called “indeterminate or transitional sleep”). NREMS is characterized by low-frequency, high-voltage EEG

The two-process model of sleep regulation

Current theoretical models suggest that there are two interacting but independent regulatory processes that control the timing, intensity, and duration of sleep (as described in the two-process model of sleep regulation; Fig. 5): one is a homeostatic sleep process and the other is a circadian sleep process [26], [27], [28].

The first regulatory process, sometimes called “Process S,” represents a sleep-wake dependent homeostatic component of sleep. Process S increases (or builds up) as a function

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    Dr. Jenni was supported by grants from the Swiss National Science Foundation (81ZH-068474 and 3200B0-112324) and Dr. Carskadon by a grant from the National Institutes of Health (grant No. MH52415).

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