Discrimination of sleep states using continuous cerebral bedside monitoring (amplitude-integrated electroencephalography) compared to polysomnography in infants

Laura Bennet, Karinna L. Fyfe, Stephanie R. Yiallourou, Henriette Merk, Flora Y. Wong, Rosemary S C Horne

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Aim: Limited two-channel electroencephalography (EEG) and amplitude-integrated EEG (aEEG) monitorings are being increasingly used; however, these measurements have not been compared with polysomnographic monitoring, the gold standard for determining infant sleep states. We aimed to determine the accuracy of two-channel EEG and aEEG recordings in defining sleep states and wakefulness in term infants compared to polysomnographic monitoring. Methods: Sleep was assessed in eight healthy term born infants (mean: 34 ± 3 days), using simultaneous polysomnography (Compumedics S-Series) and a two-channel EEG monitor (Brainz BRM2). EEG intensity, 90% spectral edge frequency (SEF), aEEG amplitude frequency bands were analysed in 30-second epochs during quiet sleep, active sleep and awake as determined by polysomnography. Results: BRM2-recorded EEG accurately identified quiet sleep from active sleep for EEG intensity (p = 0.003), SEF (p = 0.001) and aEEG amplitude (p = 0.003) and quiet sleep from awake, but not active sleep from awake. Frequency band analysis showed that wake could be identified by changes in absolute power (p = 0.015) and frequency as a percentage of total power (p = 0.03). Conclusion: We demonstrate that limited two-channel EEG monitoring can distinguish quiet sleep from active sleep and may be suitable for investigating the development of sleep in infants in the neonatal intensive care setting.

Original languageEnglish
Pages (from-to)e582-e587
JournalActa Paediatrica
Issue number12
Publication statusPublished - 1 Dec 2016


  • Brain development
  • Polysomnography
  • Preterm infants
  • Sleep states

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