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Quantitative analysis of paradoxical inward rib cage movement during sleep in children

J Kohyama1, H Sakuma, T Shiiki

  • 1Department of Paediatrics, Faculty of Medicine, Tokyo Medical & Dental University, Japan. jkohyama.ped@tmd.ac.jp

Insights

Paradoxical inward rib cage movement in children, measured by the labored breathing index (LBI), decreases with age during REM sleep. LBI effectively quantifies sleep disordered breathing severity in pediatric patients.

Area of Science:

  • Pediatric Pulmonology
  • Sleep Medicine
  • Respiratory Physiology

Background:

  • Paradoxical inward rib cage movement is a sign of labored breathing in children.
  • Respiratory inductive plethysmography is a method to measure chest wall motion.
  • The labored breathing index (LBI) quantifies this paradoxical movement.

Purpose of the Study:

  • To quantify paradoxical inward rib cage movement in children using LBI during REM sleep.
  • To investigate the age-related changes in LBI in children without obvious sleep disordered breathing (SDB).
  • To assess the correlation between LBI and SDB severity.

Main Methods:

  • Respiratory inductive plethysmography was used to measure chest wall motion.
  • The labored breathing index (LBI) was calculated during rapid eye movement sleep (REMS).
  • Data were collected from 59 children without apparent SDB.

Main Results:

  • LBI during REMS declined significantly with age in children.
  • A mature, low LBI level was observed around 35 months of age.
  • LBI demonstrated a strong correlation with the severity of SDB.

Conclusions:

  • Paradoxical inward rib cage movement, quantified by LBI, is a key indicator in pediatric SDB diagnosis.
  • LBI serves as a valuable tool for assessing breathing effort and SDB severity in children.
  • Age-related maturation of breathing patterns is reflected in LBI during sleep.

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