In this section
Note: This guideline is currently under review.
Definition of terms
Family Centred Care
This guideline provides an outline for medical, nursing and allied health staff to maximise the total hours of sleep per day for neonates in the hospital environment. This will aim to:
Neonate: An infant less than 28 days old.
Active sleep: Active sleep is analogous to rapid eye movement (REM) sleep in adults. This state involves REM underneath closed eyelids along with uneven respiration, muscle atonia and increased myoclonic jerks when compared to adults.
Quiet sleep: Quiet sleep is equivalent to non REM sleep in adults. This state involves no eye movement underneath closed eyelids, regular respiration and stillness.
Indeterminate (transitional) sleep: The state of sleep where the characteristics are not clearly defined into active sleep or quiet sleep is known as indeterminate sleep.
Sleep cycle: Neonates fall to sleep with a brief episode of active sleep, followed by a short period of indeterminate sleep before the onset of quiet sleep. Subsequent active sleep is longer. This occurs either directly from quiet sleep or through a short period of indeterminate (transitional) sleep. The cycle continues until awakening.
Sleep period: A sleep period made up of connected sleep cycles.
Sleep duration: Length of time a neonate has been asleep.
Quiet sleep (QS) - Non- REM
Indeterminate sleep (IS)
Healthy term neonates usually sleep for at least 16 - 18 hours per day. It could therefore be assumed that a sick term neonate may require at least 16-18 hours of sleep per day for normal growth and development. Preterm neonates require more than 18 hours sleep per day for normal growth and development to occur.
All neonates should be assessed on a regular basis and additional lights should be turned on for assessments.
Quiet time assists neonates to become used to sleeping in dim light and quieter environments.
Lighting should be returned to day time requirements once quiet time ends
Neonatal sleep maximisation in the hospital environment evidence table
Please remember to read the disclaimer.
development of this nursing guideline was coordinated by Laura Moore, Butterfly, Newborn Intensive Care,
and approved by the Nursing Clinical Effectiveness Committee. Updated March 2015.