Biomedical subjects
T F Anders
Publications and source records attributed to T F Anders.
Developmental course of nighttime sleep-wake patterns in full-term and premature infants during the first year of life. I.
Two groups of infants (40 normal full-term, 24 prematurely born infants) were matched on conceptional age and were studied at seven ages during the first year of life. All-night time-lapse video somnography was obtained n the home at 2, 4, 8, 20, 24, 36, and 52 weeks of age. The developmental course of sleep-wake state proportions, sleep onset indices, and special variables assessing temporal organization are compared. Age-appropriate developmental norms for sleep-wake state assessment during the first year of life are presented, using video somnography. In general, sleep-wake state ontogenesis is comparable in the two groups. The premature group is more variable from one age to the next, even though both groups demonstrate significant individual stability of some sleep-wake variables over the first year of life.
Sleep-wake state organization, neonatal assessment and development in premature infants during the first year of life. II.
Twenty four premature infants were evaluated in their homes at seven ages during the first year of life to determine whether sleep-wake state organization was related to either neonatal assessment or short-term developmental outcome measures. A model assessing environmental and biological influences on the maturational course of selected sleep-wake state parameters was also evaluated. Sleep-wake state variables and neonatal assessment items were related to each other, and both predicted developmental quotients at 6 months and 1 year of age. Concordance was present primarily in the domain of motor activities. Waking motor behaviors and motor activity in sleep seem to independently reflect an infant's level of developmental organization. Individual sleep-wake state variables were influenced by both biological and environmental factors during maturation. The developmental course of quiet sleep is primarily biologically determined, as evidenced by its relationship to the infant's birth status (gestational age or birth weight); the infant's behavior that results in being taken from the crib during the night, and the course of his/her sleep that occurs between midnight and morning are dependent on both biological factors (perhaps infant irritability), and post-birth experiences (perhaps the caregiver's response to infant irritability). The course of active sleep and wakefulness are dependent solely on environmental influences, and not on maturity at birth.
The detection of behavioral state cycles and classification of temporal structure in behavioral states.
Previous methods for the analysis of temporal structure in sleep and other state time series have described cycles, rhythms, and semi-Markov chains. Methods, however, have been subjective and arbitrary. We propose an objective system of classification for these series, based on definitions of temporal structure which are consistent with those long used in the analysis of quantitative series. An ordered sequence of statistical tests is described which classifies observed behavioral state time series into four primary categories. The system is illustrated with examples from normal infant sleep. The results show that some infant sleep series are cycles, as previously reported, some are semi-Markov chains, and some are neither. The proposed objective methods promise consistency, clarity, and a richer understanding of behaviors such as sleep.
Intrinsic and extrinsic determinants of neuronal development: relation to infantile autism.
This paper attempts to view the autistic syndrome in the context of a disorder of brain development. The authors review some of the known or suspected causes of the autistic syndrome: maternal rubella, metabolic diseases, and heredity. Some basic principles of cellular neuroanatomy and chemical neurotransmission are sketched. The stages of human brain development from neurulation through histogenesis, cell migration, and elaboration of dendritic trees and axonal projections are described. The authors conclude that there are a limited number of developmental loci that could be disrupted and lead to the autistic syndrome, and that these most probably occur in the end stages of neuronal development, after the migrating neurons have reached their final place in the brain and have begun to elaborate communicative processes. Finally, the authors speculate on how neurochemical disturbances might alter end stage neuronal differentiation leading to the pathology of infantile autism.
The child psychiatrist and research.
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Biological rhythms in development.
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Neurophysiological studies of sleep in infants and children.
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Promoting the alliance between pediatrics and child psychiatry.
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Sleep and sleepiness in children and adolescents.
We have attempted to review the current "state of the art" regarding the ontogenetic course of sleep-wake state organization and possible disruptions in this course from infancy through adolescence. It is becoming increasingly important for clinicians to learn about physiologic functioning during sleep. Much more research is required, directed at the relationship between waking behaviors and sleeping behaviors. Investigations of daytime sleepiness in adolescence, of the relationship of hyperactivity to excessive sleepiness, of the relationship between disorders such as depression and anorexia nervosa with disturbed sleep state organization, and of primary sleep disorders such as narcolepsy and the sleep apnea syndrome only scratch the surface in terms of the future work that needs to be done.
Pubertal changes in daytime sleepiness.
Nineteen children (8 girls, 11 boys) were evaluated in a total of 47 three-day sessions across three summers. Children were ranked according to Tanner's stages of secondary sexual characteristics. Nocturnal sleep was recorded from 2200 to 0800 hr each night. Multiple sleep latency tests were given at 2 hr intervals from 0930 each day. Nocturnal sleep time and REM sleep time remained constant across Tanner stages. Slow wave sleep time declined progressively across Tanner stages, with a 40% reduction from prepuberty to maturity. Daytime sleepiness was significantly greater in subjects at Tanner stages 3 and 4 than at Tanner stages 1 and 2. Subjects at Tanner stage 5 tended to be as sleepy as Tanner stage 3 and 4 subjects but did not differ significantly from the less mature subjects. No gender differences were found in daytime sleepiness for children at similar Tanner stages. More mature children were significantly sleepier at 1330 and 1530 than in the late afternoon and evening.
Enuresis: the clinical application of an etiologically based classification system.
Enuresis is a common problem of childhood, but both a theoretical understanding and an etiologically based clinical approach to the symptom are lacking. The present descriptive study was undertaken to delineate subgroups within large, heterogeneous populations of enuretic children between the ages of four and 14. A number of variables were assessed through a detailed parental history for 116 enuretic children. Several relevant and significant correlations were identified, but overall no clinically useful patterns involving sleep stages, psychopathology, environmental events, or medical or family history were discovered. The results of this study confirm recent work in the field of enuresis and emphasize the need for new research directions.
The use of the semi-Markov model in the study of the development of sleep-wake states in infants.
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Night-waking in infants during the first year of life.
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Sleep habits of children and the identification of pathologically sleepy children.
Sleep disorders and daytime sleepiness have been investigated only minimally in children. The sleep habits of 218 children, ages 10-13 years, were surveyed by a sleep habits questionnaire (SHQ). Our results demonstrate that total night time sleep on school nights begins to fall in early adolescence, whereas it remains relatively stable on non-school nights. Daytime sleepiness is not a common problem in this age group, in contrast to a college age population. We conclude that in adolescence chronic sleep deficits begin to occur which cumulatively affect later functioning. The potential use of the SHQ for depicting pathological sleepiness is also discussed.
An epidemiologic approach to school absenteeism.
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Home-recorded sleep in 2- and 9-month-old infants.
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