SLEEP 2011 Abstract Supplement

B. Clinical Sleep Science XI. Pediatrics
0787
REFINEMENT OF A SCORING SYSTEM FOR AMPLITUDE-
INTEGRATED EEG IN PRETERM INFANTS
Foreman SW, Thorngate L, Thomas KA
Family and Child Nursing, University of Washington, Seattle, WA,
USA
Introduction: The developing brain undergoes a time of rapid growth
during the third trimester when preterm infants are most susceptible to
neural disturbance and injury. Sleep-wake patterns are a vital element of
brain activity, and reflect healthy brain maturation. Amplitude-integrated
electroencephalography (aEEG) is limited channel EEG for continuous
monitoring of brain activity. aEEG interpretation relies upon visual pattern
recognition. However, there is no uniform classification standard,
thus limiting generalizability for practice and research. The purpose of
this study was to refine and operationalize an existing scoring system for
preterm infant aEEG interpretation.
Methods: Single-channel aEEG was recorded in the neonatal intensive
care unit from 16 medically stable preterm infants (mean postmenstrual
age 34.1 ± 1.5 weeks, mean postnatal age 22.6 ± 8.5 days). Each infant
was recorded once between caregiving and feeding episodes for approximately
3 hours. Tracings were evaluated visually and scored using
a modified aEEG scoring system comprising four background variables
(continuity, presence of cycling, amplitude of lower border, and bandwidth).
Scoring varies by variable with ordinal ranges 0-2, 0-4, 0-5 and
possible total score of 13. Two investigators independently completed
scoring of each recording. Percent agreement for each variable was calculated
for inter-rater reliability.
Results: 14 of the 16 recordings with satisfactory aEEG quality were
analyzed. Percent agreement in each variable resulted in: continuity
100%, cycling 64% (9/14), amplitude of lower border 94% (13/14), and
bandwidth 57% (8/14).
Conclusion: Findings indicate that of the four variables, cycling and
bandwidth were more challenging to score. Although quantifiable and
more readily measurable, the revised scoring was still quite subjective.
A further refined aEEG scoring criteria may enhance the identification
of preterm infant aEEG patterns. Reliable methods for objective scoring
including presence and description of cycling between sleep and wake
states hold promise for research in preterm brain monitoring.
Support (If Any): University of Washington School of Nursing Research
and Intramural Funding Program; National Institute of Nursing
Research T32 NR007106, F31 NR011365, P30 NR011400
0788
EFFICACY OF AN INTERNET-BASED INTERVENTION
FOR INFANT AND TODDLER SLEEP DISTURBANCES: ONE
YEAR FOLLOW-UP
Mindell JA 1,2 , DuMond C 2 , Sadeh A 4 , Kulkarni N 3 , Gunn E 3
1
Psychology, Saint Joseph’s University, Philadelphia, PA, USA,
2
Children’s Hospital of Philadelphia, Philadelphia, PA, USA, 3 Johnson
& Johnson Consumer Products Co., Skillman, NJ, USA, 4 Tel Aviv
University, Tel Aviv, Israel
Introduction: In a previous study, we found that an internet-based intervention
for infant/toddler sleep disturbances was beneficial in improving
multiple aspects of young children’s sleep, as well as maternal sleep.
The aim of this study was to assess the efficacy of this intervention one
year later.
Methods: The initial study included 264 mothers and their children
(6-36 months), with families randomly assigned to a control or one of
two intervention groups [Customized Sleep Profile (CSP) or CSP + prescribed
bedtime routine]. One year later, 171 (65%) completed a brief
10-question survey.
Results: Results of repeated measure ANOVAs (p