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Tidal breathing flow profiles during sleep in wheezing children measured by impedance pneumography

Javier Gracia-Tabuenca1, Ville-Pekka Seppä2, Milla Jauhiainen1

  • 1Faculty of Medicine and Health Technology, Tampere University, Korkeakoulunkatu 10, FI-33720, Tampere, Finland.

Respiratory Physiology & Neurobiology
|October 5, 2019
PubMed

Insights

Inhaled corticosteroids improve nocturnal breathing in wheezing children. Stopping treatment alters tidal breathing flow volume profiles, particularly during specific sleep stages, suggesting potential airflow limitation.

Area of Science:

  • Pediatric Pulmonology
  • Sleep Medicine
  • Respiratory Physiology

Background:

  • Recurrent wheezing in young children is common, often managed with inhaled corticosteroids.
  • Nocturnal breathing patterns can be altered in children with respiratory conditions.
  • Continuous overnight monitoring of breathing patterns has been limited.

Purpose of the Study:

  • To investigate the impact of inhaled corticosteroid treatment cessation on nocturnal tidal breathing flow volume (TBFV) profiles in young children with recurrent wheezing.
  • To determine how sleep stage and time from sleep onset influence these TBFV profiles.
  • To explore the potential of TBFV analysis using impedance pneumography (IP) for detecting airflow limitation during sleep.

Main Methods:

  • Seventy children (1-5 years) with recurrent wheezing underwent three overnight impedance pneumography recordings.
  • Recordings were taken 1 week before ending a 3-month inhaled corticosteroid treatment and 2 and 4 weeks after.
  • TBFV profiles were analyzed based on hour from sleep onset and estimated sleep stage (NREM, REM).

Main Results:

  • Off-medication TBFV profiles showed reduced expiratory flow peak volume and earlier expiratory interruption compared to on-medication.
  • Less convex middle expiration was observed off-medication, especially during REM sleep after 4 hours.
  • These differences were statistically significant during non-rapid eye movement (NREM) sleep for flow peak and interruption.

Conclusions:

  • Cessation of inhaled corticosteroids alters nocturnal TBFV profiles in young children with wheezing.
  • Specific TBFV features, sleep stage, and time from sleep onset can indicate airflow limitation.
  • Impedance pneumography offers a novel method for continuous, overnight TBFV analysis in pediatric respiratory research.

Keywords:
Impedance pneumographyLung functionTidal breathingWheezing children

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