Journal of Pediatric Biochemistry 2016; 06(04): 160-171
DOI: 10.1055/s-0037-1598611
Review Article
Georg Thieme Verlag KG Stuttgart · New York

Normal Sleep from Infancy to Adolescence

Silvia Miano
1   Sleep and Epilepsy Center, Neurocenter of Southern Switzerland, Civic Hospital of Lugano, Lugano, Switzerland
› Author Affiliations
Further Information

Publication History

10 October 2016

24 October 2016

Publication Date:
17 February 2017 (online)

Abstract

Age is presumably the essential factor in determining how humans sleep. Sleep patterns evolve in complex ways. This review is aimed to collect literature data about normal sleep, considering most relevant sleep studies published in the last decades, covering subjective and objective parameters, as well as neurophysiological studies on arousal development and sleep spectral analysis studies on sleep and brain maturation. According to subjective studies, sleep duration expresses the highest interindividual variability during the first years of life, becoming more stable across preschool and school ages, especially during weekend days or holidays. All these studies reported differences between sleep duration during weekday and weekend days, mostly due to earlier rise time for school time. Moreover, literature data showed a significant and worldwide decline in sleep duration and a later bedtime compared with the last century. Polysomnographic studies indicate that total sleep time in children older than 5 years did not really change with age, in contrast to what was generally suggested in several small studies. Changes seemed to be related to environmental factors rather than to biological changes. Studies about sleep microstructure (arousal levels, slow-wave activity, cyclic alternating pattern [CAP] analysis) need to be encouraged, considering the evident correlation between these sleep markers and sleep quality, brain maturation and cognition. Despite these evidences, there is a paucity of sleep normative data about CAP across developmental age, and many questions remain open about the scoring of arousals.

 
  • References

  • 1 Iglowstein I, Jenni OG, Molinari L, Largo RH. Sleep duration from infancy to adolescence: reference values and generational trends. Pediatrics 2003; 111 (2) 302-307
  • 2 Hirshkowitz M, Whiton K, Albert SM , et al. National Sleep Foundation's sleep time duration recommendations: methodology and results summary. Sleep Health 2015; 1: 40-43
  • 3 Rechtschaffen A, Kales A. A Manual of Standardized Terminology, Techniques, and Scoring System for Sleep Stages of Human Subjects. Washington, DC: Washington Public Health Service, U.S. Government Printing Office; 1968
  • 4 Iber C. Development of a new manual for characterizing sleep. Sleep 2004; 27 (2) 190-192
  • 5 Iber C, Ancoli-Israel S, Chesson AL , et al. The AASM Manual for the Scoring of Sleep and Associated Events: Rules, Terminology, and Technical Specifications, 1st ed. Westchester, IL: American Academy of Sleep Medicine; 2007
  • 6 Grigg-Damberger M, Gozal D, Marcus CL , et al. The visual scoring of sleep and arousal in infants and children. J Clin Sleep Med 2007; 3 (2) 201-240
  • 7 Jenni OG, Molinari L, Caflisch JA, Largo RH. Sleep duration from ages 1 to 10 years: variability and stability in comparison with growth. Pediatrics 2007; 120 (4) e769-e776
  • 8 Gangwisch JE, Heymsfield SB, Boden-Albala B , et al. Sleep duration as a risk factor for diabetes incidence in a large U.S. sample. Sleep 2007; 30 (12) 1667-1673
  • 9 Nunes J, Jean-Louis G, Zizi F , et al. Sleep duration among black and white Americans: results of the National Health Interview Survey. J Natl Med Assoc 2008; 100 (3) 317-322
  • 10 Maslowsky J, Ozer EJ. Developmental trends in sleep duration in adolescence and young adulthood: evidence from a national United States sample. J Adolesc Health 2014; 54 (6) 691-697
  • 11 Mindell JA, Sadeh A, Wiegand B, How TH, Goh DY. Cross-cultural differences in infant and toddler sleep. Sleep Med 2010; 11 (3) 274-280
  • 12 Galland BC, Taylor BJ, Elder DE, Herbison P. Normal sleep patterns in infants and children: a systematic review of observational studies. Sleep Med Rev 2012; 16 (3) 213-222
  • 13 National Sleep Foundation. Teens and sleep. Available at http://www.sleepfoundation.org/article/sleep-topics/teens-and-sleep . Accessed September 12, 2013
  • 14 National Sleep Foundation. How much sleep do adults need?. Available at http://www.sleepfoundation.org/article/white-papers/how-much-sleep-do-adults-need . Accessed September 12, 2013
  • 15 Centers for Disease Control and Prevention. How much sleep do I need?. Available at https://www.cdc.gov/sleep/about_sleep/how_much_sleep.html . Accessed September 10, 2007
  • 16 Centers for Disease Control and Prevention (CDC) Sleep and sleep disorders. CDC Features. Available at http://www.cdc.gov/features/sleep/ . Accessed September 25, 2011
  • 17 Hayley AC, Skogen JC, Øverland S , et al. Trajectories and stability of self-reported short sleep duration from adolescence to adulthood. J Sleep Res 2015; 24 (6) 621-628
  • 18 Dollman J, Ridley K, Olds T, Lowe E. Trends in the duration of school-day sleep among 10- to 15-year-old South Australians between 1985 and 2004. Acta Paediatr 2007; 96 (7) 1011-1014
  • 19 Keyes KM, Maslowsky J, Hamilton A, Schulenberg J. The great sleep recession: changes in sleep duration among US adolescents, 1991-2012. Pediatrics 2015; 135 (3) 460-468
  • 20 Matricciani L, Olds T, Petkov J. In search of lost sleep: secular trends in the sleep time of school-aged children and adolescents. Sleep Med Rev 2012; 16 (3) 203-211
  • 21 Matricciani LA, Olds TS, Blunden S, Rigney G, Williams MT. Never enough sleep: a brief history of sleep recommendations for children. Pediatrics 2012; 129 (3) 548-556
  • 22 Touchette E, Petit D, Séguin JR, Boivin M, Tremblay RE, Montplaisir JY. Associations between sleep duration patterns and behavioral/cognitive functioning at school entry. Sleep 2007; 30 (9) 1213-1219
  • 23 Scott N, Blair PS, Emond AM , et al. Sleep patterns in children with ADHD: a population-based cohort study from birth to 11 years. J Sleep Res 2013; 22 (2) 121-128
  • 24 Cappuccio FP, Taggart FM, Kandala NB , et al. Meta-analysis of short sleep duration and obesity in children and adults. Sleep 2008; 31 (5) 619-626
  • 25 Storfer-Isser A, Patel SR, Babineau DC, Redline S. Relation between sleep duration and BMI varies by age and sex in youth age 8-19. Pediatr Obes 2012; 7 (1) 53-64
  • 26 Ottaviano S, Giannotti F, Cortesi F, Bruni O, Ottaviano C. Sleep characteristics in healthy children from birth to 6 years of age in the urban area of Rome. Sleep 1996; 19 (1) 1-3
  • 27 Mindell JA, Meltzer LJ, Carskadon MA, Chervin RD. Developmental aspects of sleep hygiene: findings from the 2004 National Sleep Foundation Sleep in America Poll. Sleep Med 2009; 10 (7) 771-779
  • 28 Bruni O, Baumgartner E, Sette S , et al. Longitudinal study of sleep behavior in normal infants during the first year of life. J Clin Sleep Med 2014; 10 (10) 1119-1127
  • 29 Blair PS, Humphreys JS, Gringras P , et al. Childhood sleep duration and associated demographic characteristics in an English cohort. Sleep 2012; 35 (3) 353-360
  • 30 Price AM, Brown JE, Bittman M, Wake M, Quach J, Hiscock H. Children's sleep patterns from 0 to 9 years: Australian population longitudinal study. Arch Dis Child 2014; 99 (2) 119-125
  • 31 Olds T, Maher C, Blunden S, Matricciani L. Normative data on the sleep habits of Australian children and adolescents. Sleep 2010; 33 (10) 1381-1388
  • 32 Olds T, Blunden S, Petkov J, Forchino F. The relationships between sex, age, geography and time in bed in adolescents: a meta-analysis of data from 23 countries. Sleep Med Rev 2010; 14 (6) 371-378
  • 33 Leger D, Beck F, Richard JB, Godeau E. Total sleep time severely drops during adolescence. PLoS One 2012; 7 (10) e45204 . Doi: 10.1371/journal.pone.0045204
  • 34 Williams JA, Zimmerman FJ, Bell JF. Norms and trends of sleep time among US children and adolescents. JAMA Pediatr 2013; 167 (1) 55-60
  • 35 National Sleep Foundation Sleep and Teens Task Force; Adolescent Sleep Needs and Patterns: Research Report and Resource Guide. Washington, DC: National Sleep Foundation; 2000: 1-26
  • 36 Garaulet M, Ortega FB, Ruiz JR , et al. Short sleep duration is associated with increased obesity markers in European adolescents: effect of physical activity and dietary habits. The HELENA study. Int J Obes 2011; 35 (10) 1308-1317
  • 37 Gradisar M, Gardner G, Dohnt H. Recent worldwide sleep patterns and problems during adolescence: a review and meta-analysis of age, region, and sleep. Sleep Med 2011; 12 (2) 110-118
  • 38 Crowley SJ, Acebo C, Carskadon MA. Sleep, circadian rhythms, and delayed phase in adolescence. Sleep Med 2007; 8 (6) 602-612
  • 39 Carskadon MA. Maturation of processes regulating sleep in adolescents. In: Marcus CL, Carroll JL, Donnelly DF, Loughlin GM, , eds. Sleep in Children: Developmental Changes in Sleep Patterns. 2nd ed. New York, NY: Informa Healthcare; 2008: 95-109
  • 40 Ohayon MM, Carskadon MA, Guilleminault C, Vitiello MV. Meta-analysis of quantitative sleep parameters from childhood to old age in healthy individuals: developing normative sleep values across the human lifespan. Sleep 2004; 27 (7) 1255-1273
  • 41 Karacan I, Anch M, Thornby JI, Okawa M, Williams RL. Longitudinal sleep patterns during pubertal growth: four-year follow up. Pediatr Res 1975; 9 (11) 842-846
  • 42 Coble PA, Kupfer DJ, Taska LS, Kane J. EEG sleep of normal healthy children. Part I: findings using standard measurement methods. Sleep 1984; 7 (4) 289-303
  • 43 Quan SF, Goodwin JL, Babar SI , et al. Sleep architecture in normal Caucasian and Hispanic children aged 6-11 years recorded during unattended home polysomnography: experience from the Tucson Children's Assessment of Sleep Apnea Study (TuCASA). Sleep Med 2003; 4 (1) 13-19
  • 44 Montgomery-Downs HE, O'Brien LM, Gulliver TE, Gozal D. Polysomnographic characteristics in normal preschool and early school-aged children. Pediatrics 2006; 117 (3) 741-753
  • 45 Louis J, Cannard C, Bastuji H, Challamel MJ. Sleep ontogenesis revisited: a longitudinal 24-hour home polygraphic study on 15 normal infants during the first two years of life. Sleep 1997; 20 (5) 323-333
  • 46 Fattinger S, Jenni OG, Schmitt B, Achermann P, Huber R. Overnight changes in the slope of sleep slow waves during infancy. Sleep 2014; 37 (2) 245-253
  • 47 Moser D, Anderer P, Gruber G , et al. Sleep classification according to AASM and Rechtschaffen & Kales: effects on sleep scoring parameters. Sleep 2009; 32 (2) 139-149
  • 48 Scholle S, Beyer U, Bernhard M , et al. Normative values of polysomnographic parameters in childhood and adolescence: quantitative sleep parameters. Sleep Med 2011; 12 (6) 542-549
  • 49 Novelli L, Ferri R, Bruni O. Sleep classification according to AASM and Rechtschaffen and Kales: effects on sleep scoring parameters of children and adolescents. J Sleep Res 2010; 19 (1, Pt 2): 238-247
  • 50 ASDA (American Sleep Disorders Association). EEG arousals: scoring rules and examples: a preliminary report from the Sleep Disorders Atlas Task Force of the American Sleep Disorders Association. Sleep 1992; 15 (2) 173-184
  • 51 Scholle S, Wiater A, Scholle HC. Normative values of polysomnographic parameters in childhood and adolescence: arousal events. Sleep Med 2012; 13 (3) 243-251
  • 52 Boselli M, Parrino L, Smerieri A, Terzano MG. Effect of age on EEG arousals in normal sleep. Sleep 1998; 21 (4) 351-357
  • 53 International Paediatric Work Group on Arousals. The scoring of arousals in healthy term infants (between the ages of 1 and 6 months). J Sleep Res 2005; 14 (1) 37-41
  • 54 Bruni O, Novelli L, Miano S, Parrino L, Terzano MG, Ferri R. Cyclic alternating pattern: a window into pediatric sleep. Sleep Med 2010; 11 (7) 628-636
  • 55 Parrino L, Boselli M, Spaggiari MC, Smerieri A, Terzano MG. Cyclic alternating pattern (CAP) in normal sleep: polysomnographic parameters in different age groups. Electroencephalogr Clin Neurophysiol 1998; 107 (6) 439-450
  • 56 Bruni O, Ferri R, Miano S , et al. Sleep cyclic alternating pattern in normal school-age children. Clin Neurophysiol 2002; 113 (11) 1806-1814
  • 57 Bruni O, Ferri R, Miano S , et al. Sleep cyclic alternating pattern in normal preschool-aged children. Sleep 2005; 28 (2) 220-230
  • 58 Ferri R, Chiaramonti R, Elia M, Musumeci SA, Ragazzoni A, Stam CJ. Nonlinear EEG analysis during sleep in premature and full-term newborns. Clin Neurophysiol 2003; 114 (7) 1176-1180
  • 59 Miano S, PiaVilla M, Blanco D , et al. Development of NREM sleep instability-continuity (cyclic alternating pattern) in healthy term infants aged 1 to 4 months. Sleep 2009; 32 (1) 83-90
  • 60 Miano S, Peraita-Adrados R, Montesano M, Castaldo R, Forlani M, Villa MP. Sleep cyclic alternating pattern analysis in healthy children during the first year of life: a daytime polysomnographic study. Brain Dev 2011; 33 (5) 421-427
  • 61 Alves GR, Rosa A, Brito M, Pradella-Hallinan M, Tufik S. Cyclic alternating pattern in normal children aged 12 to 24 months. Arq Neuropsiquiatr 2010; 68 (5) 689-693
  • 62 Lopes MC, Rosa A, Roizenblatt S , et al. Cyclic alternating pattern in peripubertal children. Sleep 2005; 28 (2) 215-219
  • 63 Bruni O, Kohler M, Novelli L , et al. The role of NREM sleep instability in child cognitive performance. Sleep 2012; 35 (5) 649-656
  • 64 Coble PA, Reynolds III CF, Kupfer DJ, Houck P. Electroencephalographic sleep of healthy children. Part II: findings using automated delta and REM sleep measurement methods. Sleep 1987; 10 (6) 551-562
  • 65 Kurth S, Ringli M, Geiger A, LeBourgeois M, Jenni OG, Huber R. Mapping of cortical activity in the first two decades of life: a high-density sleep electroencephalogram study. J Neurosci 2010; 30 (40) 13211-13219
  • 66 Jenni OG, Carskadon MA. Spectral analysis of the sleep electroencephalogram during adolescence. Sleep 2004; 27 (4) 774-783
  • 67 Kurth S, Ringli M, Lebourgeois MK , et al. Mapping the electrophysiological marker of sleep depth reveals skill maturation in children and adolescents. Neuroimage 2012; 63 (2) 959-965
  • 68 Tononi G, Cirelli C. Sleep function and synaptic homeostasis. Sleep Med Rev 2006; 10 (1) 49-62
  • 69 Ringli M, Kurth S, Huber R, Jenni OG. The sleep EEG topography in children and adolescents shows sex differences in language areas. Int J Psychophysiol 2013; 89 (2) 241-245
  • 70 Pugin F, Metz AJ, Wolf M, Achermann P, Jenni OG, Huber R. Local increase of sleep slow wave activity after three weeks of working memory training in children and adolescents. Sleep 2015; 38 (4) 607-614
  • 71 Wilhelm I, Kurth S, Ringli M , et al. Sleep slow-wave activity reveals developmental changes in experience-dependent plasticity. J Neurosci 2014; 34 (37) 12568-12575
  • 72 Novelli L, D'atri A, Marzano C , et al. Mapping changes in cortical activity during sleep in the first 4 years of life. J Sleep Res 2016; 25 (4) 381-389
  • 73 Scholle S, Zwacka G, Scholle HC. Sleep spindle evolution from infancy to adolescence. Clin Neurophysiol 2007; 118 (7) 1525-1531
  • 74 Geiger A, Huber R, Kurth S, Ringli M, Jenni OG, Achermann P. The sleep EEG as a marker of intellectual ability in school age children. Sleep 2011; 34 (2) 181-189
  • 75 Hoedlmoser K, Heib DPJ, Roell J , et al. Slow sleep spindle activity, declarative memory, and general cognitive abilities in children. Sleep 2014; 37 (9) 1501-1512
  • 76 De Gennaro L, Marzano C, Fratello F , et al. The electroencephalographic fingerprint of sleep is genetically determined: a twin study. Ann Neurol 2008; 64 (4) 455-460
  • 77 Wahlstrom KL. Accommodating the sleep patterns of adolescents within current educational structures: an uncharted path. In: Carskadon MA, , ed. Adolescent Sleep Patterns: Biological, Social, and Psychological Influences. Cambridge, MA: Cambridge University Press; 2002: 172-197
  • 78 Hagenauer MH, Perryman JI, Lee TM, Carskadon MA. Adolescent changes in the homeostatic and circadian regulation of sleep. Dev Neurosci 2009; 31 (4) 276-284
  • 79 Cain N, Gradisar M. Electronic media use and sleep in school-aged children and adolescents: a review. Sleep Med 2010; 11 (8) 735-742
  • 80 Chaput JP, Gray CE, Poitras VJ , et al. Systematic review of the relationships between sleep duration and health indicators in school-aged children and youth. Appl Physiol Nutr Metab 2016; 41 (6, Suppl 3): S266-S282
  • 81 Danker-Hopfe H, Anderer P, Zeitlhofer J , et al. Interrater reliability for sleep scoring according to the Rechtschaffen & Kales and the new AASM standard. J Sleep Res 2009; 18 (1) 74-84
  • 82 Parrino L, Ferri R, Zucconi M, Fanfulla F. Commentary from the Italian Association of Sleep Medicine on the AASM manual for the scoring of sleep and associated events: for debate and discussion. Sleep Med 2009; 10 (7) 799-808