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Respiratory variability in preterm and term infants: Effect of sleep state, position and age

Dawn E Elder1, Angela J Campbell, Peter D Larsen

  • 1Department of Paediatrics, University of Otago Wellington, PO Box 7343, Wellington, New Zealand. dawn.elder@otago.ac.nz

Respiratory Physiology & Neurobiology
|November 30, 2010
PubMed

Insights

Sleep state significantly impacts respiratory variability in preterm and term infants. Infant position had minimal effect on breathing patterns when sleep state was accounted for.

Area of Science:

  • Neonatal physiology
  • Respiratory control in infants

Background:

  • Respiratory variability (RV) is a key indicator of cardiorespiratory health in infants.
  • Understanding factors influencing RV is crucial for assessing infant well-being, particularly in vulnerable preterm populations.

Purpose of the Study:

  • To investigate the influence of sleep state and body position on respiratory variability in preterm infants (PTIs) and term infants (TIs).
  • To compare these influences across different sleep stages (quiet vs. active sleep) and positions (prone vs. supine).

Main Methods:

  • Analysis of polysomnography data, including nasal pressure and oxygen saturation (Spo₂), from 13 PTIs and 19 TIs.
  • Determination of inspiratory onset times to calculate variability measures of the I-I interval.
  • Comparison of respiratory variability under different sleep states and positions, and with infant age.

Main Results:

  • Sleep state significantly influenced respiratory variability in both PTIs and TIs.
  • Oxygen saturation varied with sleep state only in PTIs (p=0.03).
  • Body position affected ventilatory frequency standard deviation (SDf) in PTIs (p=0.04) but not TIs. Age influenced ventilatory frequency measures in TIs, showing a decrease in SDf and CVf from birth to 3 months.

Conclusions:

  • Sleep state is the primary determinant of respiratory variability in healthy term and convalescent preterm infants.
  • Horizontal prone positioning has a limited impact on respiratory variability when sleep state is controlled.

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