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Patterns of EEG frequency, movement, heart rate, and oxygenation after isolated short apneas in infants
M F Vecchierini1, L Curzi-Dascalova, H Trang-Pham
1Service de Physiologie, Hopital Bichaty, Université Paris VII, 75877 Paris Cédex 18, France.
Insights
In infants, motor events are rare at the end of apneas, but increased EEG frequency is common. These apnea termination patterns differ significantly from normal breathing periods.
Area of Science:
- Neonatal Sleep Studies
- Pediatric Respiratory Physiology
Background:
- Limited data exists on infant apnea termination events.
- Previous studies have not compared apnea events to spontaneous breathing events.
Purpose of the Study:
- To investigate and compare event patterns at the termination of isolated apneas versus control breathing periods in infants.
- To analyze changes in EEG frequency, heart rate, and oxygen saturation following apneas.
Main Methods:
- Polysomnography was performed on 17 infants (47 ± 4 wk postconceptional age) with suspected upper airway issues.
- 163 isolated apneas and matched control ventilatory periods were analyzed.
- Occurrence of body movement, augmented breath, EEG frequency, heart rate, and oxygen saturation were recorded.
Main Results:
- Motor events (body movement or augmented breath) were significantly more common after apneas (22.0%) than control periods (12.1%).
- EEG frequency significantly increased after apneas (61% of cases) compared to control periods.
- Heart rate decreased significantly after apneas not followed by a motor event, but not after those with motor events.
Conclusions:
- Motor events are infrequent at the termination of isolated infant apneas.
- Increased EEG frequency is a common occurrence at apnea termination in infants.
- Apnea termination event patterns differ significantly from those observed during normal breathing.
Abstract:
Patterns of events occurring at the end of apneas have rarely been reported in infants. No previous studies have compared these patterns to those of spontaneous events during sleep. We examined 163 isolated apneas in 17 infants (47 +/- 4 wk postconceptional age) who underwent polysomnography for suspected upper airway problems. Mean apnea duration was 6.5+/-1.5 s (range, 5 to 11.5 s), 78% of apneas occurred in active sleep, and 67% of apneas were obstructive. We recorded the occurrence of body movement or augmented breath and analyzed changes in EEG frequency > or = 1 s, heart rate, and oxygen saturation value at the end of apneas and of a control ventilatory period defined as a period of breathing equal in duration to the apnea and preceding the apnea by 1 min. We found that 7.9% of apneas and 11.6% of control periods were followed by an augmented breath and that 14.1% of apneas and 0.5% of control periods were followed by a body movement. The percentages of motor events or no event differed significantly after the apneas (p = 0.008) compared with the control periods. A significant increase in EEG frequency was observed at the end of the apneas compared with the control periods (p < 0.04). EEG frequency increased after 61% of the apneas. Neither heart rate nor oxygen saturation value changed after the control periods. Heart rate decreased significantly after the apneas not followed by a motor event (p = 0.02) but not after the apneas followed by a body movement. We conclude that 1) at termination of isolated apneas in infants, a motor event was rare, whereas an EEG frequency increase was common; 2) event patterns at apnea termination differed from those at control period termination.