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American Academy of Pediatrics
Article

Circadian Rhythms in Infants

Scott A. Rivkees, Majid Mirmiran and Ronald L. Ariagno
NeoReviews November 2003, 4 (11) e298-e304; DOI: https://doi.org/10.1542/neo.4-11-e298
Scott A. Rivkees
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Majid Mirmiran
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Ronald L. Ariagno
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Objectives

After completing this article, readers should be able to:

  1. Describe how circadian rhythms are generated.

  2. Describe how lighting influences the circadian system.

  3. Delineate the period during which the origin of circadian rhythms develops.

  4. Describe the relationship between maternal circadian rhythms and the development of circadian rhythms in infants.

  5. Characterize the potential sequelae of impaired fetal and early neonatal circadian rhythms related to sleep patterns.

  6. Describe beneficial lighting patterns for preterm infants in the neonatal intensive care nursery.

Biology of Circadian Rhythmicity in Infants

Circadian rhythms are endogenously generated rhythms that have a period length of about 24 hours. Evidence gathered over the past decade indicates that the circadian timing system develops prenatally, with the suprachiasmatic nuclei (SCN) in the anterior hypothalamus, the site of a circadian clock, present by mid-gestation in primates. Recent evidence also shows that the circadian system of primate infants is responsive to light at very early stages (as early as 25 to 28 weeks’ gestation in humans) and that low-intensity lighting can regulate the developing clock. After birth, circadian system outputs mature progressively, with rhythms in sleep-wake cycles, body temperature, and hormone production generally developing between 1 and 3 months of age. The importance of light in regulation of circadian rhythm in infants is highlighted by the early establishment of rest-activity patterns that are in phase with the 24-hour light-dark cycle in preterm infants exposed to low-intensity cycled lighting. With the continued elucidation of circadian system development and influences on human physiology and illness, it is anticipated that consideration of circadian biology will become an increasingly important component of neonatal care.

The Circadian Timing System

Notable examples of circadian rhythms include the sleep-wake cycle and daily rhythms in body temperature and hormone production. Circadian rhythms are also involved in the pathogenesis of illnesses, such as reactive airway disease (eg, asthma) and myocardial infarction.

The system responsible …

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NeoReviews
Vol. 4, Issue 11
1 Nov 2003
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Circadian Rhythms in Infants
Scott A. Rivkees, Majid Mirmiran, Ronald L. Ariagno
NeoReviews Nov 2003, 4 (11) e298-e304; DOI: 10.1542/neo.4-11-e298

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Circadian Rhythms in Infants
Scott A. Rivkees, Majid Mirmiran, Ronald L. Ariagno
NeoReviews Nov 2003, 4 (11) e298-e304; DOI: 10.1542/neo.4-11-e298
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    • Objectives
    • Biology of Circadian Rhythmicity in Infants
    • Circadian Rhythm Development in Infants: Evidence-based Recommendations for Clinical Care
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