The rhythm of a preterm neonate’s life: ultradian oscillations of heart rate, body temperature and sleep cycles


The objectives are to characterize oscillations of physiological functions such as heart rate and body temperature, as well as the sleep cycle from behavioral states in generally stable preterm neonates during the first 5 days of life. Heart rate, body temperature as well as behavioral states were collected during a daily 3-h observation interval in 65 preterm neonates within the first 5 days of life. Participants were born before 32 weeks of gestational age or had a birth weight below 1500 g; neonates with asphyxia, proven sepsis or malformation were excluded. In total 263 observation intervals were available. Heart rate and body temperature were analyzed with mathematical models in the context of non-linear mixed effects modeling, and the sleep cycles were characterized with signal processing methods. The average period length of an oscillation in this preterm neonate population was 159 min for heart rate, 290 min for body temperature, and the average sleep cycle duration was 19 min. Oscillation of physiological functions as well as sleep cycles can be characterized in very preterm neonates within the first few days of life. The observed parameters heart rate, body temperature and sleep are running in a seemingly uncorrelated pace at that stage of development. Knowledge about such oscillations may help to guide nursing and medical care in these neonates as they do not yet follow a circadian rhythm.

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The clinical study was supported by SNSF funding from Sven M. Schulzke: Grant Number 141206. René Koch is a scientific freelancer and joined the project without any financial support.

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Correspondence to Gilbert Koch.

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Preliminary data analysis was presented as poster at an international conference. The authors have no conflicts of interest to disclose.

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Koch, G., Jost, K., Schulzke, S.M. et al. The rhythm of a preterm neonate’s life: ultradian oscillations of heart rate, body temperature and sleep cycles. J Pharmacokinet Pharmacodyn (2021).

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  • Oscillations
  • Ultradian rhythm
  • Prematurity
  • Sleep
  • Chronological alignment