Abstract Introduction Background Sleep is a critical biological process for brain maturation, synaptic organization, and neurodevelopment during the neonatal period. In Neonatal Intensive Care Units (NICUs), environmental stressors such as excessive light, noise, and frequent handling disrupt physiological sleep–wake organization, potentially affecting recovery and prognosis. Despite increasing evidence linking sleep quality to neurodevelopmental outcomes, sleep-protective strategies remain insufficiently implemented in NICUs. Methods We performed a prospective interventional study including 35 neonates admitted to the NICU with gestational ages ranging from 26 to 38 weeks. Diagnoses included neonatal sepsis (n=8), germinal matrix hemorrhage (n=12), severe prematurity with marked neurological immaturity (n=15), and other associated critical conditions. All neonates underwent polysomnographic (PSG) studies adapted for neonatal age before and after implementation of sleep-protective measures, including reduction of ambient light and noise, scheduled maternal contact periods, and the use of a prototype NICU cradle designed to optimize sleep conditions. Results Post-intervention PSG demonstrated improved organization of sleep–wake cycles. By pathology: neonatal sepsis showed recovery in 6 of 8 cases (75%) with 2 deaths (25%); germinal matrix hemorrhage showed improvement in 11 of 12 neonates (91.7%) with 1 death (8.3%); severe neurological immaturity improved in 13 of 15 cases (86.7%) with 2 deaths (13.3%). Improvements were observed independently of length of hospitalization. Conclusion Targeted sleep-protective interventions in the NICU are associated with meaningful improvements in recovery and prognosis across multiple neonatal pathologies. Sleep optimization represents a low-risk, non-pharmacological strategy translating neurodevelopmental principles from bench to bedside, with potential long-term benefits for critically ill neonates. Support (if any) no
Rivas et al. (Fri,) studied this question.