OD11 Bidirectional Effects: Infant Sleep and Neurodevelopment


The wealth of new knowledge about infant sleep and its disorders is not widely recognized; yet infant sleep is the bold new frontier of pediatric sleep medicine. This symposium provides a comprehensive up-to-date review of how to evaluate and treat sleep disorders in neonates and infants, cognizant of the bidirectional relationships between sleep and development.

Infant sleep has traditionally been viewed as a biomarker of brain health, with various pathologies associated with abnormal sleep phenotypes. However, we present compelling evidence in this symposium that infant sleep and neurodevelopment are bidirectional, suggesting clinical interventions that support healthy sleep can be impactful even in neurologically compromised infants.

Among healthy preterm and term newborns, the sensory environment shifts with sleep-wake cycling. Given that the neonatal brain is hyper-sensitive to sensory input - even while asleep - these interactions may explain the predictive association between newborn sleep-wake architecture and neurodevelopment. Similarly, for newborns who require intensive care, development of sleep-wake cycling is emerging as a key and objective marker of brain functional integrity and a predictor of long-term neurodevelopment.

Sleep disordered breathing results in gas exchange abnormalities, and these together can affect sleep stability in infants impacting early neuronal maturation and plasticity. Although sleep disordered breathing is not that uncommon in term and pre-term infants, it is not well recognized or treated. Hence early diagnosis and management of sleep-disordered breathing in infants holds the potential for optimizing infant's sleep, overall health and long-term neurodevelopment outcomes and wellness.

Our panel of dynamic and accomplished speakers have all agreed to present should this session be selected. They will review the latest science and clinical applications of sleep for our youngest patients. This engaging session will highlight key areas of research with attention to practical application for clinicians.

Learning Objectives

Upon completion of this CME activity, participants should be able to:

      • Describe the interactions between neonatal sleep-wake cycling and sensory processing
      • Recognize how the emergence of neonatal sleep-wake cycling reflects but then may also feed into infant brain development
      • Explain the associations between objective neonatal sleep measures, and long-term neurodevelopment
      • Recall the American Academy of Pediatrics new clinical practice guideline definition for BRUE (Brief Resolved Unexplained Events, formerly called ALTE), and the relationships between BRUE, Sudden Infant Death Syndrome (SIDS) and sleep
      • Identify various patterns of sleep disordered breathing in infants, its impact on development and its management
      • Recognize the video-PSG features of parasomnias, sleep-related seizures, and sleep-related movements in infants

Target Audience

Clinicians who evaluate and treat infants and children for sleep disorders and their consequences or who treat patients in inpatient settings; investigators who study development of sleep-wake physiology and novel objective sleep measures.


Renee Shellhaas (United States)

Is sleep state-dependent sensory processing a mechanistic bridge between sleep and neurodevelopment?

Kimberley Whitehead (United Kingdom)

The relationship between sleep and outcomes in neonatal ICU survivors 

Renee Shellhaas (United States)

Impact of sleep disordered breathing on infant development

Umakanth Katwa (United States)

Parasomnias, sleep-related movements and seizures in fetuses and infants

Madeleine Grigg-Damberger (United States)

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