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Hypoxic arousal responses in normal infants.

S L Ward1, D B Bautista, T G Keens

  • 1Division of Neonatology and Pediatric Pulmonology, Childrens Hospital Los Angeles, University of Southern California School of Medicine 90027.

Pediatrics
|May 1, 1992
PubMed
Summary

Many healthy infants fail to arouse from sleep when exposed to low oxygen levels. This impaired arousal response to hypoxia may be a factor in sudden infant death syndrome (SIDS).

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Area of Science:

  • Pediatric Sleep Medicine
  • Neonatal Physiology

Background:

  • Infant arousal failure during hypoxia is a potential mechanism for Sudden Infant Death Syndrome (SIDS).
  • Most SIDS deaths occur in infants not previously identified as high-risk.

Purpose of the Study:

  • To investigate the hypothesis that healthy infants may fail to arouse from sleep in response to hypoxia.
  • To assess the prevalence of hypoxic arousal disorders in a cohort of healthy term infants.

Main Methods:

  • 18 healthy term infants (<7 months) underwent hypoxic arousal challenges during quiet sleep.
  • Inspired oxygen tension was rapidly reduced to 80 mm Hg to test arousal responses.
  • Arousal was defined by eye opening, agitation, or crying; tests were repeated when feasible.

Main Results:

  • Only 44% of infants (8/18) aroused during at least one hypoxic challenge.
  • Arousal occurred in only 32% of all hypoxic trials.
  • Periodic breathing post-hypoxia was significantly more common in infants who failed to arouse (94%) compared to those who did (13%).

Conclusions:

  • A significant proportion of healthy term infants exhibit impaired arousal from sleep in response to hypoxia.
  • The failure to arouse, rather than the hypoxic ventilatory response itself, may be critical in SIDS.
  • Periodic breathing following hypoxia is strongly associated with a lack of arousal.

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