. Author manuscript; available in PMC: 2020 Nov 2.

Published in final edited form as: Pediatr Clin North Am. 2019 Apr;66(2):353–367. doi: 10.1016/j.pcl.2018.12.006

Table 5.

Infant sleep-wake states

Infant State	Description

1. Quiet sleep	Nearly still, with the occasional startle or twitch

2. Active sleep	Some body movements
	Rapid eye movements
	May smile or make fussy sounds

3. Drowsy	Variable activity level; the infant may startle and open and close eyes

4. Quiet alert	Attentive with eyes wide and bright
	Regular breathing

5. Active alert	Variable activity
	Eyes open but dull or glazed
	Irregular breathing
	May have periods of fussiness

6. Crying	Increased activity
	Skin color changes present
	Eyes tightly closed or open
	Responsive to stimuli

Adapted from Brazelton TB. Neonatal behavioral assessment scale. Clinics in developmental medicine No 50, 1973. p. 5–8. with permission. Available at: http://nidcap.org/wp-content/uploads/2013/12/Brazelton-1973-BNBAS.pdf.