Sleep rhythmicity in premature infants: implications for development status.

Ultradian and diurnal rhythms in premature infants were investigated by assessing cyclicity of quiet sleep (QS) and the diurnal distribution of this cyclicity. The sleep of 49 preterm infants was recorded in the hospital for three successive 24-hour periods at 36 weeks conceptional age (CA), and 42 of the infants were recorded in the home for two 24-hour periods when they were 6 months old. Sleep was recorded nonintrusively by means of the motility monitoring system, which does not require instrumentation of the subject. Cyclicity was assessed using a procedure that permits assessment of significance as well as degree of cyclicity. Twenty of the 49 infants at the preterm age and 37 of the 42 infants at 6 months had sleep episodes with significant cyclicity. Mean cyclicity scores increased from 0.61 to 0.81 over age, but the cycle length of approximately 60 minutes did not change. There was no evidence for individual consistency across the two ages in any of the sleep or cyclicity measures. Evidence for diurnal differences was present from the preterm period. At both ages, there were far more analyzable sleep episodes and higher cyclicity at night. At the preterm period, cyclicity measures were negatively related to indices of advanced perinatal status as well as 6-month mental scores; at 6 months, the cyclicity measures were positively related to perinatal measures as well as mental scores. These results indicate the necessity for different interpretations of periodicity at the preterm and later age.(ABSTRACT TRUNCATED AT 250 WORDS)

Cardiovascular and other physical effects of acute administration of naltrexone in autistic children.

ABSTRACT The physical side effects of acutely administered naltrexone (0.5, 1.0, 1.5, and 2.0 mg/kg, orally) were compared with placebo in 13 children (3-12 years old) with autism. Heart rate, systolic blood pressure, mean arterial blood pressure, and axillary body temperature were obtained before and 1 h after placebo or drug administration. Serum concentrations of the liver enzymes glutamic-oxaloacetic transaminase (SGOT) and glutamic-pyruvic transaminase (SGPT) were obtained 1 h and 24 h after drug. In comparison with placebo, no significant effects of any of the four doses of naltrexone were found on any of these measures. Three hours after administration, there were no significant effects of acute naltrexone on EKG parameters (heart rate, axis, PR, QRS, QT, or QTc) compared to predrug values. These data support the safety of acute administration of naltrexone on vital signs, EKG, and liver function in preadolescent children with autism and are consistent with studies in healthy normotensive adults. In view of prior findings that naltrexone can alter cardiovascular function in certain pathologic states (including some that involve increased opioid peptide activity) and findings of increased opioid activity in some autistic individuals, the absence of cardiovascular effects of naltrexone in autistic children is tentatively suggestive of the safety of acutely administered naltrexone. Since chronic high doses of naltrexone can increase liver transaminase levels in adults, it remains advisable for clinicians to monitor liver function in children receiving chronic naltrexone treatment. Other adverse effects of acute naltrexone in these children appeared to be minimal.