Monitoring of brain maturation with amplitude integrated electroencephalography during phototherapy treatment in newborns

Hyperbilirubinemia is a common problem in the neonatal period. Although the bilirubin level requiring treatment depends on the gestational age, birth weight and postnatal age of the baby, the first choice of treatment is phototherapy. Amplitude integrated electroencephalography (aEEG) monitoring has been widely used in neonatal units. It is valuable in the detection of background activity, sleep-wake cycle and seizure activity in newborns. We aimed to evaluate the effect of light on aEEG recordings in neonates under phototherapy treatment. Term newborns admitted to the neonatal intensive care unit for phototherapy treatment were subjected to aEEG monitoring for the first 6 hours under phototherapy treatment and sleep-wake cycles and background activity measurements were recorded. For the next 6 hours, phototherapy treatment was interrupted, eye pads were removed and aEEG monitoring was performed and sleep-wake cycles and background activity measurements were recorded. The recorded results, demographic data of the patients and hospitalization days were statistically compared. The study included 64 term newborns. 43 (67%) were male, mean birth weight was 3174± 417 and median birth week was 38 (37-41). During phototherapy, the median sleep-wake cycle was 8 (4-12), the median lower background activity was 6 (4-10), and the median upper background activity was 18 (10-24) for 6 hours, while the median sleep-wake cycle was 6 (3-10), the median lower background activity was 6 (5-10), and the median upper background activity was 18 (12-25) when phototherapy was discontinued. When the Wilcoxon signed-rank test was performed between the two groups, a statistically significant difference was found between the sleep-wake cycles (p<0.001). As a result of our study, sleep-wake cycles of term newborns were determined to increase during phototherapy. This suggests that significant hyperbilirubinemia does not adversely affect the sleep-wake cycle. We also think that the sleep-wake cycle increases with the effect of light exposure during phototherapy treatment. This indicates that, to the best our knowledge, this study may be the first study to demonstrate that phototherapy has an effect on the sleep-wake cycle.