Abstract

 

The Role of Sleep in Shaping Neonatal Brain Development

The neonatal period represents a critical window for brain development, marked by rapid maturation and heightened plasticity. Disruptions during this phase can lead to long-lasting cognitive, behavioral, and emotional challenges with substantial socioeconomic implications for affected individuals, families, and society. Advances in neonatal care have improved survival rates, yet preterm birth, now affecting 1 in 10 births, remains the leading cause of developmental disorders in Europe. Early diagnosis and intervention for neurologic conditions in newborns is therefore essential to optimize neurodevelopmental outcomes.

Within this discipline, which examines all types of behavior, the main focus is on the role of sleep as the predominant behavioral state in neonates and a driver of endogenous brain activity critical for development. Advances in monitoring and imaging technologies, including EEG, NIRS, and high-frame-rate ultrasound, alongside innovations in digital health and biosensors, now allow precise quantification of brain maturation and neurobehavioral states in preterm infants.

Dr. Howard P. Roffwarg’s foundational hypothesis published in 1966, that "REM sleep provides an important endogenous stimulation that facilitates the development of the central nervous system" has been further substantiated by groundbreaking animal studies by Mark Blumberg and colleagues over the past decade. Building upon these insights, this lecture will present how we have developed the first bedside monitoring system to quantify sleep in preterm infants and its relationship to MRI-assessed brain development, bridging decades of research with real-time clinical application.