{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T11:25:25Z","timestamp":1790853925707,"version":"4.1.0"},"reference-count":53,"publisher":"American Academy of Pediatrics (AAP)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[1999,3,1]]},"abstract":"<jats:sec><jats:title>Objective.<\/jats:title><jats:p>The Task Force of The American Academy of Pediatrics (1996) recommends the nonprone sleeping position for asymptomatic preterm infants to prevent sudden infant death syndrome. The mechanism by which the nonprone sleeping position reduces the rate of sudden infant death syndrome is unclear for full-term infants and the precise effect of sleeping position on sleep and cardiorespiratory characteristics has never been addressed in preterm infants. The purpose of the present study was to clarify the effect of sleeping position on sleep and cardiorespiratory characteristics in preterm infants at an age when they are ready for discharge.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design.<\/jats:title><jats:p>Sixteen asymptomatic preterm infants were studied in both supine and prone sleeping positions at 36.5 \u00b1 0.6 weeks' postconceptional age using videosomnography. Sleep, respiratory, and heart rate characteristics were compared between the two positions using each infant as his\/her own control.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results.<\/jats:title><jats:p>More awakenings (ie, arousals \u226560 seconds) were seen during all sleep states in the supine sleeping position but overall the total sleep and percent sleep state were not affected by sleeping position. After each feeding, the first quiet sleep was significantly shorter, with more heart rate variability and awakenings in the supine position. There were no significant differences in the occurrence of arousals (&amp;lt;60 seconds) or the incidence or severity of apnea and periodic breathing. No clinically significant apnea (\u226515 seconds), bradycardia, or oxygen desaturations were seen.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion.<\/jats:title><jats:p>In 36-week-postconceptional age preterm infants, the supine sleeping position had less quiet sleep and was associated with greater heart rate variability during the first sleep cycle after the feeding. More awakenings were seen during all sleep states in the supine position. These data support the American Academy of Pediatrics recommendation for \u201cBack to Sleep\u201d for asymptomatic preterm infants because more awakenings and lower threshold for arousal may provide some benefit for the infant responding to a life-threatening event. However, further studies are needed to address positional effect on the physiologic measures in preterm infants at older ages (later stages of development). Precisely what constitutes the most healthy or advantageous sleep for newborn infants remains an important question.<\/jats:p><\/jats:sec>","DOI":"10.1542\/peds.103.3.603","type":"journal-article","created":{"date-parts":[[2004,8,13]],"date-time":"2004-08-13T23:45:45Z","timestamp":1092440745000},"page":"603-609","source":"Crossref","is-referenced-by-count":67,"title":["More Awakenings and Heart Rate Variability During Supine Sleep in Preterm Infants"],"prefix":"10.1542","volume":"103","author":[{"given":"Kazuya","family":"Goto","sequence":"first","affiliation":[{"name":"From the Department of Pediatrics, Stanford University School of Medicine, Stanford, California; the"},{"name":"Department of Pediatrics, Oita Medical University, Oita, Japan; and the"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Majid","family":"Mirmiran","sequence":"additional","affiliation":[{"name":"From the Department of Pediatrics, Stanford University School of Medicine, Stanford, California; the"},{"name":"Netherlands Institute of Brain Research, Amsterdam, The Netherlands."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marian M.","family":"Adams","sequence":"additional","affiliation":[{"name":"From the Department of Pediatrics, Stanford University School of Medicine, Stanford, California; the"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robyn V.","family":"Longford","sequence":"additional","affiliation":[{"name":"From the Department of Pediatrics, Stanford University School of Medicine, Stanford, California; the"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roger B.","family":"Baldwin","sequence":"additional","affiliation":[{"name":"From the Department of Pediatrics, Stanford University School of Medicine, Stanford, California; the"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Margaret A.","family":"Boeddiker","sequence":"additional","affiliation":[{"name":"From the Department of Pediatrics, 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