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Rapid eye movement sleep, apnea, and cardiac slowing influenced by phenobarbital administration in the neonate

M Gabriel, M Albani

    Pediatrics
    |October 1, 1977
    PubMed

    Insights

    Phenobarbital (phenobarbitone) reduced active sleep and neurogenic apnea/bradycardia in preterm infants. As drug levels decreased, these symptoms returned, supporting a neurophysiologic link between active sleep and apnea.

    Area of Science:

    • Neonatal Medicine
    • Neurophysiology
    • Pharmacology

    Background:

    • Neonatal apnea and bradycardia are significant concerns in preterm infants.
    • The neurophysiological mechanisms underlying these events are not fully understood.
    • Phenobarbital is a commonly used medication in neonatal care.

    Purpose of the Study:

    • To evaluate the effect of phenobarbital on neonatal sleep behavior.
    • To assess the impact of phenobarbital on the incidence of neurogenic apnea and/or bradycardia.
    • To investigate the relationship between phenobarbital serum levels, active sleep, and apnea/bradycardia.

    Main Methods:

    • Polygraphic recordings were conducted in seven preterm infants.
    • Infants received phenobarbital to achieve therapeutic serum levels.
    • Sleep patterns and the occurrence of apnea/bradycardia were monitored.

    Main Results:

    • Therapeutic phenobarbital levels decreased active sleep and the incidence of apnea/bradycardia.
    • Apnea and bradycardia predominantly occurred during active sleep.
    • As phenobarbital levels declined, active sleep rebounded, and apnea/bradycardia recurred.

    Conclusions:

    • Phenobarbital effectively reduces active sleep and associated apnea/bradycardia in preterm infants.
    • The findings support the hypothesis that active sleep facilitates neonatal apnea.
    • Active sleep-inhibitory brain mechanisms may play a role in the pathophysiology of neonatal apnea.

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