Published online September 1, 2004
PEDIATRICS Vol. 114 No. 3 September 2004, pp. 592-600 (doi:10.1542/peds.2003-0651-L)
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Sleep of Excessively Crying Infants: A 24-Hour Ambulatory Sleep Polygraphy Study

Jarkko Kirjavainen, MD*, Liisa Lehtonen, MD{ddagger}, Turkka Kirjavainen, MD§ and Pentti Kero, MD{ddagger}

* Pediatric Neurology and Clinical Neurophysiology
{ddagger} Pediatrics, Turku University Hospital, Turku, Finland
§ Department of Pediatrics, Hospital for Children and Adolescents, Helsinki, Finland

Objective. Parents’ reports suggest that excessively crying or colicky infants sleep less compared with control subjects. The aim of this study was to determine the sleep-wake structure of excessively crying infants throughout a 24-hour cycle.

Methods. A 24-hour sleep polygraphy study was conducted at home for 24 excessively crying infants and 23 control subjects at the age of 6 weeks. In addition, parental diaries were kept for 4 days.

Results. In sleep polygraphy recordings, no major differences between study groups were observed in either the duration or the structure of the 24-hour sleep. In the diaries, the parents overestimated the amount of sleep in both study groups. The parents of the control infants overestimated the amount of sleep more than the parents of excessively crying infants (69.8 minutes [standard deviation: 79.3] compared with 27.1 minutes [standard deviation: 65.4], respectively). In excessively crying infants, the proportion of rapid eye movement sleep was higher during the 3-hour period from the beginning of the first long sleep in the evening and lower during the preceding 3-hour period compared with the control group.

Conclusions. The results of this study suggest that diary-based studies are prone to be biased as the parents of the control infants are more likely to overestimate the amount of infant’s sleep and, therefore, report more sleep than the parents of the crying infants. Although no differences in the total amount of sleep or proportions of sleep stages were observed, excessively crying infants may be characterized by a disturbance that affects rapid eye movement and non–rapid eye movement sleep stage proportion during evening hours.

Key Words: cry • infant • infantile colic • sleep • polysomnography • rapid-eye-movement sleep • behavioral states

Abbreviations: REM, rapid eye movement • NREM, non–rapid eye movement • EEG, electroencephalogram • EMG, electromyogram

Accepted Feb 17, 2004.


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