Importance of sleep and rest
The metabolic demands of fever are high and,
therefore, sickness behaviour is considered an
energy-saving mechanism (Straub et al 2010).
Imeri and Opp (2009) proposed that sleep
during infection promotes recovery and that
alterations in the types of sleep observed during
infection are tailored to support the production
of fever. As discussed, thermoregulation is
dependent on the sleep-wake cycle. During
infection, the amount of time spent in non-REM
sleep increases, reducing energy expenditure,
particularly those energy reserves used up by
children moving around and playing. REM
sleep is considerably reduced in the early stages
of fever, which means that shivering, crucial to
fever generation, can occur because shivering
does not take place during REM sleep. When
the inflammatory response is initiated because
of infection, the concentrations of inflammatory
cytokines increase, in particular IL-1β and
TNF-