Awakening and Sleep-Wake Cycle Across Development (Advances in Consciousness Research)

290 Pages·2002·2.14 MB·English

by  Piero Salzarulo

AwakeningandSleep-WakeCycleacrossDevelopment
Advances in Consciousness Research
Advances in Consciousness Research provides a forum for scholars from
differentscientificdisciplinesandfieldsofknowledgewhostudyconsciousness
initsmultifacetedaspects.ThustheSerieswillinclude(butnotbelimitedto)
thevariousareasofcognitivescience,includingcognitivepsychology,linguis-
tics, brain science and philosophy. The orientation of the Series is toward
developingnewinterdisciplinaryandintegrativeapproachesfortheinvestiga-
tion, description and theory of consciousness, as well as the practical conse-
quencesofthisresearchfortheindividualandsociety.
SeriesB:Researchinprogress.Experimental,descriptiveandclinicalresearch
inconsciousness.
Editor
MaximI.Stamenov
BulgarianAcademyofSciences
EditorialBoard
DavidChalmers,UniversityofArizona
GordonG.Globus,UniversityofCaliforniaatIrvine
RayJackendoff,BrandeisUniversity
ChristofKoch,CaliforniaInstituteofTechnology
StephenKosslyn,HarvardUniversity
EarlMacCormac,DukeUniversity
GeorgeMandler,UniversityofCaliforniaatSanDiego
JohnR.Searle,UniversityofCaliforniaatBerkeley
PetraStoerig,UniversitätDüsseldorf
†FranciscoVarela,C.R.E.A.,EcolePolytechnique,Paris
Volume38
AwakeningandSleep-WakeCycleacrossDevelopment
EditedbyPieroSalzaruloandGianlucaFicca
Awakening and
Sleep-Wake Cycle
across Development
Edited by
Piero Salzarulo
UniversityofFlorence
Gianluca Ficca
SecondUniversityofNaples
JohnBenjaminsPublishingCompany
Amsterdam(cid:1)/(cid:1)Philadelphia
TM ThepaperusedinthispublicationmeetstheminimumrequirementsofAmerican
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Awakeningandsleep-wakecycleacrossdevelopment /editedbyPieroSalzarulo,Gianluca
Ficca.
p. cm.(AdvancesinConsciousnessResearch,issn1381–589X;v.38)
Includesbibliographicalreferencesandindex.
1.Sleep-wakecycle.2.Developmentalneurobiology.I.Salzarulo,Piero.II.Ficca,
Gianluca.III.Series.
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Table of contents
Awakening:Whichchangesacrossdevelopment? 
PieroSalzarulo
1. Methodologicalissues
Developmentofwakefulness:Re-awakeninganeglectedtopic 
BrianHopkins
Methodologicalissuesinthestudyofarousalsandawakenings
duringsleepinthehumaninfant 
MarieJ.Hayes
Awakeningfrominfants’sleep:Someremarksondefinitions,
methodologyandresearchissues 
GianlucaFicca
Arousalsininfantsduringthefirstyearoflife:
Argumentfornewdefinitionsandcriteria 
RonaldL.Ariagno,MajidMirmiran,andRobertA.Darnall
2. Trendsofsleep-wakecycleandawakeningsacrossthedevelopment
Spontaneousarousalandawakeninginpretermandfull-terminfants 
LiliaCurzi-Dascalova,HeinzZotter,RonaldL.Ariagno,and
MajidMirmiran
Awakeningandsleep-wakecycleininfants 
IginoFagioli,GianlucaFicca,andPieroSalzarulo
Awakeningsinschoolagechildren 
OlivieroBruni,S.Miano,E.Verrillo,S.Galiffa,andS.Ottaviano
 Tableofcontents
3. Physiologicalandenvironmentalinfluencesonawakenings
Awakenings,sleep-wakecycleandthermalenvironmentinneonates 
VéroniqueBach,FrédéricTelliez,PierluigiLenzi,KarenChardon,
AndréLeke,andJean-PierreLibert
Timepatternanalysisofactivity-restrhythmsinfamilies
withinfantsusingactigraphy 
KatharinaWulffandRenateSiegmund
Theeyesofparentsoninfantsawakening 
FiorenzaGigantiandMonicaToselli
Mother-infantrelationshipasamodulatorofnightwaking 
AnatScher
4. Clinicalcontexts
Sleepfragmentationandawakeningduringdevelopment:
Insightsfromactigraphicstudies 
AviSadeh
Arousalsandawakeningsininfancy:Evaluationforclinicalcontext 
MarieFrançoiseVecchieriniandYvonneNavelet
Arousalresponsestohypercapniaandhypoxiaininfants
andchildren 
ClaudeGaultier
Thescoringofarousalsininfants:Areportontheongoingwork
ofthePediatricWake-UpClub 
JosèGroswasser,PatriciaFranco,T.Simon,SoniaScaillet,
FilomenaValene,AlainDeBroca,andAndréKahn
Indexofnames 
Indexofterms 
Awakening
Which changes across development?
PieroSalzarulo
DepartmentofPsychology,UniversityofFlorence
Sleep-wakefulnessrhythmundergoesimpressivechangesacrossdevelopment:
both sleep and wakefulness change not only in duration and temporal orga-
nization,butalsoinphysiologicalandbehaviouralqualities.Allthesefeatures
have been extensivelydescribed in the last decades (for reviewssee Salzarulo
& Fagioli, 1999; Curzi & Challamel, 2000).The trendwith developmentcon-
sistsintheconsolidationofsleepepisodesoflongerdurationduringthenight
and in the lengthening of wakefulness episodes during the day. Within this
frame it is easily understandablethat awakening is a crucial event.Neverthe-
less, contributions on this topic are relatively scarce. They come from differ-
entstreamsofinvestigation,sometimeswithdifferentterminologies.Thereare
experimental researches on normal babies speaking about ‘awakening’, clini-
calapproachesreferringto‘nightwaking’,andinvestigationsaboutrespiratory
pathologieswhich oftenusetheterm‘arousal’(seeforinstanceGroswasseret
al.contribution,thisvolume).
It is important to examine the conceptual frame which underlieseach of
these domains; there are methodological and epistemological aspects which
needtobeunderscored.
Experimental research showed frequency and age distribution in normal
infants and was also intended to shed light on the processes which lead to
awakening. Awakening was characterized by the appearance of behavioural
manifestations of wakefulness (for a review see Hayes and Fagioli et al., this
volume).
Nightwakingisaconceptmainlyusedinpediatricandpsychologyprac-
ticewhichisrelatedtoanexcessivefrequencyand,aboveall,durationofwake-
fulness during the night as a consequenceof a single or of multiple awaken-
 PieroSalzarulo
ings. While the causes are multiple (see Messer & Richards, 1993 for a re-
view), emphasis is put on practical approaches to solve this disturbing event
forfamilies.
Athirdapproachcomesmainlyfromthefieldofrespiratorydisturbances
and uses a differentterm, ‘arousal’, which is often considered an ‘equivalent’
of awakening. Some authors, as Thach & Lijowska (1996), speak about ‘full
arousal’ to indicate ‘awakening’. In fact, this is an intriguing problem which
deservessomecommentsandshouldbeclarified.Theterm‘arousal’,notonly
in the fieldof respiratorydisturbancesduring development,oftenindicatesa
changeinthedepthofsleep,which resumes(infactitneverdisappeared)af-
terashorttimeintervalmeasuredinseconds(ASDA,1992).Theseshorttime
eventshavebeeninterpretedassignsofphysiologicalactivation.Toclarifythe
situation, a main research challenge could be to compare awakening features
witharousalfeatures,asfarastheprocessesleadingtoandtheirconsequences
areconcerned.
Besidesthedefinitionofthemainfeaturescharacterisingeach(arousaland
awakening),thecontinuitybetweenthetwoisofinterest(atopicevokedalso
byHayesandFiccainthisvolume).Istheawakeningthetransformationofthe
arousal?Isarousalanecessaryeventprecedingawakening?Thach &Lijowska
(1996),forinstance,considersighsand‘trashing’(i.e.motorevents),signsof
‘arousal’necessarilyprecedingthe‘fullarousal’(i.e.‘awakening’).Chughetal.
(1996),speakingabouttheadult,areinfavourofacontinuumbetweenarousal
andawakening,whereasScheretal.(1992),instudiesonbabies,pinpointthe
markeddifferencebetweenthemechanismsregulatingthetwo.Afurtherques-
tion:isarousalanexpressionofatemporaryshortinstabilityoftheCNSactiv-
ity,whileawakeningisa‘true’changeofstate?Evidencecouldcomealsofrom
thestudyofthedevelopmentaltrendsofbothevents:doarousaladawakening
sharethesametrends(i.e.changewithage)?Ifnot,thiscouldbeanadditional
argumenttoseparatethem.
Itisimportanttorememberthatawakeningisatransitionbetweentwodif-
ferentmodesofCNSfunctionning(Wolff,1984),facingeachother:sleepstate
and wakefulness state. Time and modalities for passing the frontier (Garma,
1994) between these two blocks depend on several factors. First, the intrin-
sic features of each ‘block’ which are linked to maturation. Then, the ability
of the brain to reconstructa differentmode of activity, which consistsin the
coordination of several physiological functions. The modalities of transition
willbemoreorlesssmoothorabrupt,mainlyonthebasisofthesecapacities.
Thetransitionprocessshouldhaveitstimecourse,whichhoweverisatpresent
poorlyknown.AschematicsequencehasbeenproposedrecentlybyThachand
Awakening:Whichchangesacrossdevelopment? 
Lijowska(1996),basedonrespiratoryandmotorevents;astudytakingintoac-
counttheEEGactivitylevelprecedingspontaneousbehaviouralawakeningin
infantsiscurrentlybeingperformedinourlab(Zampietal.,2001).
Wakefulnessisimportantfordevelopment(Salzarulo&Fagioli,1995)and
itscharacteristicschangewithage(Wolff,1984).Thus,speakingaboutawaken-
ing,itseemsimportanttotakeintoaccountthekindofwakefulnesswhichfol-
lowsasafunctionofage.Wakingupfordoingwhat?Justmove,lookaroundor
interactwithobjects, persons?Therearepossibilitieswhich couldbeunavail-
ableatthe beginningof life,andbecome a ‘choice’ onlylater.Modalitiesand
processesoftransitionbetweensleepandwakefulnesscoulddependalsofrom
therepertoireofwakefulnessthatinfantshaveattheirdisposalasexpressionof
theirmaturationalstep(seeHopkinscontribution,thisvolume).
Inthisbook,inordertodevelopsomeofthetopicsmentionedabove,we
decidedtoincludeasetofpapersbycolleagueswhomadesignificantcontribu-
tionsinthefieldandwhoareinvolvedinthestudyoftheprecociousdevelop-
mentofbehaviouralandphysiologicalcomponentsofsleepandwakefulness.
Thebook,mainlydealingwiththeissuesdiscussedduringameetingheld
inFlorence,April14–15,2000(partiallysupportedbyUniversityofFlorence),
isintendedtopresentcontributionsfrombothexperimentalandclinicalfields.
Someofthepapersrefertoongoingdiscussionswithinaworkinggroup(Wake
up club) on a developing consensus about criteria to define awakening and
arousal.
A first set of papers will raise methodological and theoretical problems
dealing with awakening during development: in particular, the above men-
tioned confrontation “arousal vs awakening”,which implies the construction
andtheagreementoncriteriafordefiningeach(seeHayes,FiccaandAriagno
contributions). Closely connected is the definition(s) of wakefulness(es) as a
function of age, from its emergence to further qualitative and quantitative
development(seeHopkinscontribution).
Asecondgroupofpaperswilldescribechangesinawakeningfrompreterm
infants to school-age children (see Curzi et al.; Fagioli et al.; Bruni et al. pa-
pers).Theyincludebothsystematicdatacollecteduptonowandsuggestions
oncriteriaaswellasonmodelswhichcouldaccountforprocessesinvolved.In
anycase,theyareausefulbackgoundforcomparisonwithresultsobtainedin
clinicalcontexts.
Physiological and environmental factors influencing awakening will be
consideredinathirdsection.Interactionwithtemperatureregulationisatopic
of particular interest,since it raises the problemof the modalities of adapta-
tiontoexternalconditionsandofmechanismsofbiologicalregulationatearly