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How to Obtain Reliable Visual Event-related Potentials in Newborns
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Characterizing cardiorespiratory interaction in preterm infants across sleep states using visibility graph analysis.

Dandan Zhang1,2, Xi Long1,2, Lin Xu3

  • 1Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands.

Journal of Applied Physiology (Bethesda, Md. : 1985)
|February 4, 2021
PubMed
Summary

Cardiorespiratory interaction (CRI) in preterm infants differs across sleep states and postmenstrual age (PMA). Quiet sleep shows stronger, more regular CRI, potentially aiding sleep state differentiation.

Keywords:
cardiorespiratory interactionpreterm infant sleepvisibility graph

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Area of Science:

  • Neonatal Physiology
  • Complex Systems Analysis
  • Cardiorespiratory Dynamics

Background:

  • Cardiorespiratory interaction (CRI) is well-studied in adults but under-investigated in preterm infants across various sleep states.
  • Understanding CRI in preterm infants is crucial for assessing their physiological development and well-being.
  • Previous research has not explored the nonlinear dynamics of CRI in different sleep states (wake, active sleep, quiet sleep) of preterm infants.

Purpose of the Study:

  • To quantify and analyze cardiorespiratory interaction (CRI) in preterm infants during different sleep states.
  • To investigate the influence of postmenstrual age (PMA) on CRI characteristics in preterm infants.
  • To apply advanced nonlinear methods for a deeper understanding of CRI complexity in neonatal sleep.

Main Methods:

  • Utilized the visibility graph (VG) method for nonlinear analysis of CRI in preterm infants.
  • Extracted network parameters (mean degree, clustering coefficient, assortativity, complexity) from CRI data for each sleep state.
  • Analyzed the interaction effects of sleep state and PMA on CRI parameters.

Main Results:

  • Significant interaction effects between sleep state and PMA were observed for most CRI parameters.
  • Sleep state significantly impacted CRI parameters, except for the clustering coefficient (CCm).
  • Postmenstrual age (PMA) significantly influenced CRI parameters, except for complexity (D_SE).
  • Quiet sleep (QS) exhibited more regular, stratified, and stronger CRI compared to active sleep (AS) and wake (W).

Conclusions:

  • Cardiorespiratory interaction (CRI) in preterm infants is significantly associated with both sleep state and postmenstrual age (PMA).
  • CRI demonstrates a more clustered pattern in preterm infants with higher PMA across sleep states.
  • The distinct CRI patterns observed across sleep states, particularly in QS, suggest potential for using these parameters to differentiate sleep states in preterm infants.