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Sleep state, hypoxia and periodic breathing in the neonate
1Neonatal Research Unit, London Hospital Medical College, England.
Insights
Newborns exposed to low oxygen (hypoxia) are more likely to experience periodic breathing during quiet sleep than active sleep. The duration of breathing pauses was also longer in quiet sleep, suggesting sleep state influences respiratory patterns in infants.
Area of Science:
- Neonatal physiology
- Respiratory control
- Sleep science
Background:
- Periodic breathing is a common respiratory pattern in newborns.
- Sleep state can influence cardiorespiratory control in infants.
- Hypoxia is a known trigger for periodic breathing.
Purpose of the Study:
- To investigate the impact of sleep state on hypoxia-induced periodic breathing in term infants.
- To compare the occurrence and characteristics of periodic breathing during quiet versus active sleep.
Main Methods:
- Full-term infants were studied during their first week of life.
- Exposure to 15% oxygen (hypoxia) was administered.
- Periodic breathing, transcutaneous pO2, and sleep state were monitored.
Main Results:
- Periodic breathing occurred more frequently in quiet sleep (7/42) than active sleep (5/20) during hypoxia (p<0.05).
- The duration of periodic apnea was significantly longer in quiet sleep compared to active sleep.
- Hypoxia sometimes coincided with a change in sleep state, possibly influencing both.
Conclusions:
- Sleep state significantly influences the occurrence and duration of hypoxia-induced periodic breathing in term newborns.
- Quiet sleep appears to be a more vulnerable state for developing prolonged periodic breathing during hypoxia.
- Further research is needed to understand the interplay between sleep state, hypoxia, and respiratory control in neonates.
Abstract:
The influence of sleep state on hypoxia-induced periodic breathing was evaluated in full-term babies studied during the first week of life. Following exposure to 15% O2, periodic breathing occurred in 7 of 42 babies during quiet sleep, and 5 of 20 during active sleep (p less than 0.05). The median levels of transcutaneous pO2 at which periodic breathing occurred during hypoxia, and was abolished on reoxygenation were similar in each sleep state. The median duration of periodic apnoea was significantly greater in quiet than active sleep. In 7 babies the occurrence of periodic breathing during hypoxia was accompanied by a change in sleep state. This was probably coincidental in 3 cases, but in the other 4 babies hypoxia may have induced both the change in state and breathing pattern.