Related Experiment Video
Updated: Aug 29, 2025
Intratracheal Instillation of Stem Cells in Term Neonatal Rats
Published on: May 4, 2020
Supplemental Oxygen Treats Periodic Breathing without Effects on Sleep in Late-Preterm Infants
Maija Seppä-Moilanen1, Sture Andersson1, Turkka Kirjavainen1
1Children's Hospital, and Pediatric Research Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
Insights
Supplemental oxygen effectively reduces periodic breathing and oxygen desaturations in preterm infants. This intervention does not significantly impact sleep architecture or quality in these vulnerable newborns.
Area of Science:
- Neonatal Medicine
- Pediatric Sleep Medicine
- Respiratory Physiology
Background:
- The impact of supplemental oxygen on sleep patterns in preterm infants remains largely uninvestigated.
- Periodic breathing and oxygen desaturations are common concerns in preterm neonates.
Purpose of the Study:
- To evaluate the effect of supplemental oxygen on sleep characteristics in stable late-preterm infants with periodic breathing.
- To assess changes in periodic breathing, central apneas, and oxygen desaturations with supplemental oxygen administration.
Main Methods:
- Polysomnography was conducted on 18 stable late-preterm infants (median gestational age 36 weeks).
- Infants were studied under two conditions: room air and 25% oxygen-enriched ambient air.
Main Results:
- Supplemental oxygen significantly reduced periodic breathing (10% to 1% of total sleep time) and central apneas (48 to 23 per hour).
- Oxygen desaturations (≥3%) decreased significantly (38 to 10 per hour) with supplemental oxygen.
- No significant effects were observed on sleep stage distribution, sleep efficiency, or spontaneous arousals.
Conclusions:
- Supplemental oxygen is effective in mitigating periodic breathing and oxygen desaturations in late-preterm infants without disrupting sleep architecture.
- Findings suggest that carotid body over-reactivity plays a crucial role in the development of periodic breathing in preterm infants.
Background:
The effect of supplemental oxygen on sleep has not been studied in preterm infants.
Methods:
We studied 18 stable late-preterm infants with observed periodic breathing at a median gestational age of 36 weeks. Polysomnography was performed on room air and on 25% oxygen-enriched ambient air.
Results:
Supplemental oxygen did not affect sleep stage distribution, sleep efficiency, the frequency of sleep stage transitions, the appearance of rapid-eye movement (REM) sleep periods, or the high number of spontaneous arousals. The percentage in periodic breathing out of total sleep time decreased from 10% (interquartile range [IQR] 5-9%) on room air to 1% (IQR 0-3%) (p < 0.001) on supplemental oxygen. Also, the number of central apneas decreased from 48 (IQR 32-68) to 23 (IRQ 15-32) per hour (p < 0.001), and the number of oxygen desaturations of a minimum 3% from 38 (IQR 29-74) to 10 (IQR 5-24) per hour (p < 0.001). On room air in non-REM sleep, the median end-tidal carbon dioxide values were systematically lower during periodic breathing at 5.1 (IQR 4.6-6.4) kPa than during stable breathing at 5.5 (4.9-5.9) kPa (p < 0.0001).
Conclusions:
In late-preterm infants, supplemental oxygen effectively reduces periodic breathing and the number of oxygen desaturations while having no significant effect on sleep. The results support the importance of carotid body over-reactivity on the genesis of periodic breathing in preterm infants.
Related Concept Videos
01:16Treatment for Pulmonary Arterial Hypertension: Oxygen Therapy for Respiratory Failure
Oxygen therapy is vital in increasing and maintaining blood oxygen levels in PAH patients. As a result, it aids in reducing fatigue,...
01:19Respiratory Assessment: Purpose and Indications
Objectives and Importance:
The primary goal of respiratory assessment is to evaluate patients at early risk of clinical deterioration. Since respiratory distress often precedes other signs of declining health, breathing patterns and sounds become a...
01:26Oxygen Delivering System I: Nasal Cannula and Face Mask
Nasal Cannula
A nasal cannula is a lightweight tube split at one end into two prongs and placed in the nostrils. It is typically used to deliver low to medium levels of oxygen.
Suggested flow rate: The suggested flow rate for a nasal cannula typically ranges between 1 and 6 L/min.
Oxygen percentage setting:...
01:30Administering Oxygen by Mask
Administering oxygen by mask is a common nursing intervention that provides supplemental oxygen to patients with respiratory distress or chronic lung conditions. This procedure involves delivering oxygen at a specified rate through a face mask connected to an oxygen source.
Equipment
The equipment necessary for this procedure includes:
01:16Oxygen Delivering System II: Venturi Mask and Transtracheal Oxygen
Venturi Mask
The Venturi mask, named after the Venturi effect, is designed to deliver precise oxygen concentrations. It consists of a large tube with an oxygen inlet that narrows down, causing a pressure drop that pulls air in through adjustable side ports. The mask is a lightweight,...
01:23Physiological Control of Respiration
Breathing, a seemingly passive process, is regulated by the respiratory center in the brainstem. This center coordinates the involuntary control of respirations, which means it occurs without conscious effort, ensuring a smooth and uninterrupted pattern.
Regulation of Ventilation
The body maintains ventilation by monitoring levels of carbon dioxide (CO2), oxygen (O2), and hydrogen ion concentration (pH) in the arterial blood. Among these factors, the level of CO2 plays a crucial...