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Paradoxical inward rib cage motion during rapid eye movement sleep in infants and young children
C Gaultier1, J P Praud, E Canet
1Laboratory of Physiology, Hospital Antoine Beclere, Clamart, France.
Insights
Paradoxical rib cage motion during rapid eye movement sleep decreases with age in infants. This change in breathing patterns may be linked to growth-related shifts in chest wall mechanics.
Area of Science:
- Pediatric Pulmonology
- Sleep Medicine
- Developmental Physiology
Background:
- Neonatal respiratory patterns during rapid eye movement (REM) sleep often feature paradoxical inward rib cage motion during inspiration.
- Understanding the developmental trajectory of these breathing patterns is crucial for assessing respiratory health in infants and children.
Purpose of the Study:
- To investigate whether the duration of paradoxical inward rib cage motion during REM sleep diminishes from infancy through early childhood.
- To compare respiratory gas exchange during paradoxical rib cage motion in infants with findings in neonates.
Main Methods:
- Polysomnography (electroencephalogram, electrooculogram, electromyogram) was used to monitor sleep stages in 13 healthy infants (7–31 months).
- Respiratory airflow, rib cage and abdominal dimensions (magnetometers), and diaphragmatic electromyographic activity were recorded.
- Transcutaneous partial pressure of oxygen (PtcO2) was continuously monitored.
Main Results:
- A significant negative correlation was found between age and the duration of paradoxical inward rib cage motion during REM sleep (r = -0.66, P < 0.02).
- This suggests that paradoxical rib cage motion becomes less prevalent as infants mature.
- Unlike neonates, infants in this study showed no decrease in PtcO2 during paradoxical inward rib cage motion, indicating stable oxygenation.
Conclusions:
- The duration of paradoxical inward rib cage motion during REM sleep decreases significantly with age during infancy and early childhood.
- This developmental change is likely influenced by alterations in chest wall compliance and rib cage geometry.
- Infants maintain adequate oxygenation during REM sleep despite paradoxical rib cage motion, differing from neonatal observations.
Abstract:
In neonates, rib cage motion on inspiration during rapid eye movement sleep is almost exclusively paradoxical. We wondered whether or not duration of paradoxical inward rib cage motion on inspiration during rapid eye movement sleep decreases in infancy and early childhood. Thirteen healthy infants from 7 to 31 months of age were tested during natural afternoon naps. Electroencephalogram, electrooculogram and electromyogram were all recorded. Airflow was measured by nasal and buccal thermistors, abdominal and rib cage anteroposterior diameters by magnetometers. Transcutaneous partial pressure of O2 was monitored. Diaphragmatic electromyographic activity was recorded using surface electrodes. The average total sleep time was 138 min ranging from 107 to 186 and rapid eye movement sleep time amounted to 15% of total sleep time ranging from 6 to 25. During rapid eye movement sleep, the total duration of paradoxical inward rib cage motion was measured and expressed as a percentage of rapid eye movement sleep time. We found that duration of paradoxical inward rib cage motion during rapid eye movement sleep decreased significantly with age (r = -0.66, P less than 0.02) which may be explained by the changes in chest wall compliance and geometry of the rib cage occurring with growth. We observed no decrease in transcutaneous partial pressure in O2 during paradoxical inward rib cage motion during rapid eye movement sleep in infants in contrast to that reported in neonates.