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Effects of naloxone on apnoea duration during sleep in infants at risk for SIDS
Insights
Naloxone, an opiate antagonist, did not affect respiratory patterns or periodic apnoea in infants with severe sleep apnoea syndrome. This suggests endorphins may not cause, but rather result from, infant sleep apnoeas and potentially SIDS.
Area of Science:
- Neonatal Medicine
- Respiratory Physiology
- Neuropharmacology
Background:
- Infants with sleep apnoea syndrome exhibit elevated endogenous opioid (endorphin) levels.
- The role of these endorphins in respiratory control during sleep remains unclear.
Purpose of the Study:
- To investigate the effect of the opiate antagonist naloxone on respiratory control in infants with severe sleep apnoea syndrome.
- To determine if endogenous opioids contribute to the pathogenesis of infant sleep apnoea and sudden infant death syndrome (SIDS).
Main Methods:
- Intravenous administration of naloxone (0.005-0.4 mg/kg) to six infants with severe sleep apnoea syndrome.
- Monitoring of respiratory pattern, apnoea duration, and frequency before and after naloxone administration.
Main Results:
- Naloxone administration, irrespective of dose, showed no significant effect on respiratory pattern.
- The occurrence and characteristics of periodic apnoea remained unchanged following naloxone treatment.
Conclusions:
- Endogenous opioids do not appear to play a major role in the pathogenesis of sleep apnoea syndrome in infancy.
- Elevated endorphin levels in infants with sleep apnoea may be a consequence of hypoxic stress rather than a causative factor.
Abstract:
The effects of intravenous injections of the opiate antagonist naloxone (0.005-0.4 mg/kg body weight) on respiratory pattern, apnoea duration and frequency were investigated in six infants with severe sleep apnoea syndrome. Since several authors found elevated plasma- and CSF-levels of endogenous opioids (endorphines) in infants with sleep apnoea syndrome, we wanted to determine whether the impairment of the control mechanisms of respiration during sleep is due to an effect of endogenous opioids. Independent of the dose, naloxone did not exert any effect on respiratory pattern and occurrence of periodic apnoea. We were unable to prove that endorphines play a major role in pathogenesis of sleep apnoea syndrome in infancy and possibly in sudden infant death syndrome (SIDS). We speculate that elevated levels of endorphines reported by some investigators rather seem to be a consequence of hypoxic stress than a cause for sleep apnoeas.