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Effects of Cycled Lighting on Heart Rate in Preterm Infants: Comparing the Use of Standard and Individual Heart Rate Criteria

Although some studies have suggested beneficial effects of abrupt cycled lighting (CL) intervention, potential adverse effects during and after transitions may result in stress in preterm infants. An earlier study by this investigator, using classical mean value methods of analysis, showed unclear differences in heart rate (HR) between the abrupt and gradual CL groups. Thus the purpose of this secondary analysis was to examine the effects of gradual versus abrupt changes in CL on the HR of preterm infants, comparing the use of standard and individual criteria. Thirteen healthy preterm infants between 3 1.1 and 34.6 weeks post-conceptional age were studied, using a single-case and quasi-experimental repeated measures design. Comparisons were made within and between groups, and in individual infants among HRs across four time blocks at AM (6:30-830) and PM (630-830) on 5 days, using repeated measures analysis of variances (ANOVAs) and t-tests. In this present study, results within and between the abrupt and gradual CL groups consistently found significant percentages of above normal mean HR, using individual criteria. Infants cared for in the gradual CL environment did have more stability in HR than did the abrupt CL infants. These finding suggest that the use of individual criteria for detecting HR changes for CL intervention may be a more sensitive measure than the use of standard criteria or classical mean values. Gradual CL contributed to greater selfregulation of HR than abrupt CL. However, gradual transitions from dark to light were more stressful in this respect than transitions from light to dark.