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University of Iowa team studies sleep in premature infants • Iowa Capital Dispatch [1]
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Date: 2025-04-10
When a pregnant person receives an ultrasound, often the fetus inside the womb is seen moving in some way.
The youngest humans sleep the most, University of Iowa researcher Mark Blumberg said, but that sleep doesn’t look like an adult cat nap — it’s full of twitches and other movements.
For infants born prematurely, however, the environment in which they’re resting changes dramatically much sooner than normal, meaning much of their development is happening outside of the womb. This provides a powerful insight into the relationship between sleep and human development at its earliest stages, scientists say.
UI researchers are working with university hospital Neonatal Intensive Care Unit (NICU) staff and families with infants in their care to log the sleep patterns of premature babies. The researchers are hoping to learn more about connections between sleep and development in early life and to use that knowledge to educate parents and ensure infants are getting the best sleep they can when they need it most.
“Being able to basically have these externalized fetuses that allow us to actually measure directly what they’re doing, we think we’re getting a very accurate assessment of what their sleep is like,” Blumberg said. “It’s not as comfortable or as quiet or as contained as what’s happening in the womb, but it’s our best chance to understand what sleep is like in premature infants.”
Blumberg, a UI professor and chair of the psychological and brain sciences department, is leading the five-year study, with $3.1 million in funding from the National Institute of Child Health and Human Development, a branch of the National Institutes of Health.
Blumberg’s study of sleep extends back more than 20 years when he started looking at the sleep patterns, specifically unconscious twitching, and brain development of baby rats. Questions he and others sought to answer led from wondering why infants sleep so much when they’re young to why infants move so much while they sleep.
It turns out that twitching in sleep actually drives brain activity due to sensory input from the moving limb, he said. Around a decade ago, he began trying to understand sleep twitching and brain development in humans. He first worked with full-term infants before moving to premature infants.
Human babies cycle in and out of sleep quite often, Blumberg said, as often as every five to 15 minutes, and they can produce thousands of movements while in these periods of sleep. Researchers physically logged each facial and body movement made by the infants they studied while equipment monitored any spikes in brain function that occurred during twitches.
“There’s no AI for doing this yet, it’s a very complicated process to distinguish these movements,” Blumberg said. “We do it through actual human beings scoring these movements, and so it’s very, very time intensive and requires a lot of expertise.”
What they’ve found so far is that the most brain activity an infant has is when it is asleep and moving, Blumberg said, outpacing even the brain activity seen when the baby is awake. Full-body twitches are more common when infants are at their youngest, but finer movements in the fingers and toes show up later. The location and quantity of twitches also changes with age, he said, showing that the baby’s structure of sleep is changing.
The team is still learning about the movements and how they change, but Blumberg said he believes there are really exciting things to gain knowledge on in a number of areas if they keep watching.
“It’s just a black box, we don’t know what we’re going to find,” Blumberg said. “We have ideas, but we need to see them, and part of it is just really getting into the details of what’s going on with their breathing and their brain activity and their movements, and how all of those things link together.”
Lacey Kline, the mother of two prematurely born children and born early herself, enrolled her now toddler, William, in the study after he was born at just 23 weeks. He spent 135 days in the University of Iowa Hospitals and Clinics NICU, sometimes with a network of sensors on his head and researchers logging his every movement and twitch while sleeping.
The odds of survival for a baby born as early as William was have gotten a lot better than they were just 15 years ago, Kline said, largely due to medical advances made through scientific research.
“My thought is, you know, he likely would not have been here … if this would have been a long time ago,” Kline said. “So what can we do to help future babies?”
Publication and education
Researchers will conduct follow-up meetings this summer with the families they worked with more than two years ago, Blumberg said, in order to track their development over time and see if they have developed any disorders more commonly found in preterm infants. Gathering this data could lead to possible early detection of disorders based on sleep metrics.
In addition to follow-up meetings helping to drive research forward, UI researcher Greta Sokoloff said the team will also start compiling data together for its first paper and work with communities to educate about what sleep looks like in infants and its importance.
Sleep appears very different between infants and adults, Sokoloff said, and teaching parents about what to expect as normal from their sleeping baby and best practices will help assuage fears.
“I think there’s just a lot of lack of information, I guess, for people to really understand what sleep is supposed to look like in these kids,” Sokoloff said.
A movement to ensure sleep is undisturbed for newborn infants is already sweeping through European countries, Blumberg said — one he hopes will hop across the pond and make its way to the U.S.
In the past, Blumberg said neonatal care units were brightly lit and loud, creating an environment babies would have an incredibly hard time sleeping in. NICUs have improved over the years to be quieter and dim to disturb resting infants less, but he said more steps need to be taken to ensure babies’ development isn’t impacted by the need to monitor them.
“What they’re doing in Europe, and I have a close colleague in the Netherlands who’s doing this, is literally monitoring when the kids are awake and they’re asleep, and then making sure that they’re only disturbed when they’re awake,” Blumberg said. “These sorts of things, I think, are going to be super important for the future health of kids in NICUs.”
Researchers face uncertain funding future
Like many research teams across the U.S., Sokoloff said the group is currently waiting to hear back about the continuation of the NIH funding for the project’s fourth year. This is the correct time for the organization to get back to them, she added, but with federal changes and court challenges adding to an uncertain situation, she doesn’t know how much operations have slowed.
“We have good hopes that we, for sure, will get our continuation for our fourth year, but they could have to cut the budget,” Sokoloff said.
Blumberg shared Sokoloff’s hopes for the study’s continued funding, but said it’s “hard to focus some days” knowing that bad news could be headed his way. In his more than 30 years as a professor, Blumberg said he’s never seen anything like what’s going on at the federal level relating to necessary funding for important work.
Federal funding for multiple UI programs have already been cut or canceled entirely, including the International Writing Program, Iowa Flood Center and Iowa Geological Survey. Graduate students have also voiced concerns about funding cuts potentially leaving them without work.
There are “tremendous” amounts of fear and instability among the research community, Blumberg said, and to call people “terrified” is an undersell. He added that fear may be one of the goals behind all of the changes.
“I’m hopeful, but for the first time in my career, I’m fearful that things could be cut off in the middle,” Blumberg said. “And I know people who’ve had their grants canceled … It’s not just an unwarranted fear.”
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