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What did the project achieve?
“This work has provided important new evidence about the vital role sleep plays in early brain development, as well as a new way for researchers to study what is happening inside the newborn brain during this crucial period,” says Professor Topun Austin of Cambridge University Hospitals NHS Foundation Trust. “In the long term, this could help neonatal units better support healthy sleep patterns in premature babies, giving them the best possible start in life.”
Thanks to major advances in neonatal care, more preterm babies are surviving than ever before – but they remain at an increased risk of long-term neurodevelopmental complications. There are many reasons for this, but one contributing factor may be that the environment in the neonatal intensive care unit (NICU), with its bright lights, background noise and frequent medical procedures, disrupts the natural sleep cycles that are essential for healthy brain development.
To investigate this, the researchers developed a new, non-invasive imaging system to study sleep patterns and brain development in newborn babies. The system uses a lightweight, flexible cap containing small light sources and sensors that gently track changes in blood flow across different areas of the brain. This allows researchers to examine how ‘functional brain networks’ develop, while babies sleep comfortably in their cots.
The team successfully used this new system to collect and analyse data from a group of healthy, full-term babies – the first time wearable technology has been used for cot-side neuroimaging in newborn infants. Using this approach, they showed that different sleep states are linked with distinct patterns of functional connectivity in the developing newborn brain – and data collection is ongoing for a group of preterm babies receiving care in the NICU.
“Sleep is something newborns spend much of their time doing, yet it remains surprisingly under-researched,” says Professor Austin. “Being able to show a clear link between sleep states and brain development provides a strong evidence base for prioritising sleep protection in neonatal care. If these early findings are confirmed, they could have a major impact on how babies are cared for in the NICU.”
This project has now led to a follow-on study, which will provide further evidence on the importance of protecting sleep in the neonatal unit – with a particular focus on the impact of noise. The team has also set up an international group to advance collaborative research into sleep in newborn babies and infants.
This research was completed on
How are children’s lives affected now?
Around one in every 13 babies in the UK is born too soon – before 37 weeks of pregnancy.1,2 Although medical treatments are improving, preterm babies who survive have a higher risk of lifelong disabilities than those born full-term.
“The causes of neurodevelopmental complications in premature babies are complex and involve many factors,” says Professor Austin.
In the second half of pregnancy, a baby’s brain undergoes a period of rapid development, forming new connections and networks. At the same time, distinct sleep states emerge, with the baby cycling between so-called ‘active’ and ‘quiet’ periods of sleep. For babies born preterm and cared for in neonatal units, the frequent medical procedures, bright lights and loud noises may interrupt these natural sleep cycles essential for healthy brain development.
”This interruption of the natural cycling of sleep states could impact on the formation of important brain networks, and ultimately affect their neurodevelopmental outcomes,” says Professor Austin.
How could this research help?
“We aim to relate natural sleep cycles with the development of brain connections in preterm and full-term babies,” says Professor Austin.
Using a non-invasive imaging system consisting of a lightweight, flexible cap worn on the baby’s head, the team will study changes in blood flow in different parts of the brain which are the basis of the brain networks. In a previous pilot study, the researchers identified differences in blood flow and brain networks between distinct sleep states.
“We will then use sophisticated statistical techniques to look for differences in brain networks between active and quiet periods of sleep – and between preterm and full-term babies,” says Professor Austin.
The team will also collect information about the preterm babies’ environment that may interrupt their sleep cycles, such as background noise and routine care.
Ultimately, we hope to develop a new system for use in neonatal units that can help to promote sleep cycling and support healthy brain development in these vulnerable babies.
- Office for National Statistics, Vital statistics in the UK: births, deaths and marriages - 2019 https://www.ons.gov.uk/peoplepopulationandcommunity/populationandmigration/populationestimates/datasets/vitalstatisticspopulationandhealthreferencetables [website accessed 08 February 2021]
- National Institute for Health and Care Excellence, Preterm labour and birth final scope April 2013 http://www.nice.org.uk/guidance/gid-cgwave0660/resources/preterm-labour-and-birth-final-scope2
Research table
Project details
| Project Leader | Professor Topun Austin, BSc MBBS MRCP(Paed) PhD |
| Location | Neonatal Intensive Care Unit, Rosie Hospital, Cambridge University Hospitals NHS Foundation Trust |
| Project Team |
Dr Robert Cooper, MPhys PhD
Professor Jeremy Hebden, BSc PhD Dr Ronit M Pressler, MD MRCPCH PhD |
| Other Locations |
Department of Medical Physics and Biomedical Engineering, University College London
Department of Neurophysiology, Cambridge University Hospitals NHS Foundation Trust |
| Grant Awarded | |
| Grant Amount | £119,802 |
| Start Date | |
| End Date | |
| Duration | 24 months |
| Grant Code (GN number) | GN2859 |
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