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Anterior fontanelle pressure variations during sleep in healthy infants
J L Wayenberg1, D Hasaerts, P Franco
1Department of Paediatrics, Hôpital Français-Reine Elisabeth, Brussels, Belgium.
Insights
Intracranial pressure (ICP) in infants increases during transient and REM sleep, with plateau waves appearing in these stages. Quiet sleep shows flatter ICP, highlighting sleep-related cerebrovascular changes.
Area of Science:
- Pediatric Neurology
- Sleep Medicine
- Neurophysiology
Background:
- Intracranial pressure (ICP) monitoring is crucial in infants, but physiological variations during sleep are not well understood.
- Understanding normal ICP fluctuations is essential for accurate clinical interpretation in pediatric neurocritical care.
Purpose of the Study:
- To investigate intracranial pressure (ICP) variations in healthy infants across different sleep stages.
- To analyze mean basal ICP, pulse pressure amplitude, and plateau/B-like wave activity during sleep.
Main Methods:
- Continuous, noninvasive ICP measurement during polysomnography in 12 healthy infants (1-11 months old).
- Analysis of ICP parameters across transient sleep, quiet sleep (stages 2 & 3), and rapid eye movement (REM) sleep.
Main Results:
- Mean ICP, mean pulse pressure amplitude, and B-like wave amplitude significantly increased during transient and REM sleep.
- Plateau waves were observed predominantly during transient and REM sleep.
- ICP recordings were relatively stable during quiet sleep stages 2 and 3.
Conclusions:
- ICP variations and pressure waves during infant sleep are linked to sleep-associated cerebrovascular changes.
- Knowledge of physiological ICP dynamics during sleep is vital for interpreting continuous ICP monitoring in infants.
Abstract:
Our aim was to study the intracranial pressure (ICP) variations during sleep normal infants. Using a noninvasive method, ICP was measured continuously during polysomnography in 12 healthy infants aged from 1 to 11 months (median 3.5 months). We analyzed the variations of mean basal ICP, mean basal pulse pressure amplitude and maximal amplitude of both plateau and B-like waves between transient sleep, quiet sleep and rapid eye movement (REM) sleep. Mean ICP, mean pulse pressure amplitude and B-like wave amplitude increased significantly during transient sleep and REM sleep. Plateau waves occurred during transient sleep and especially REM sleep. By contrast, noninvasive ICP recordings were relatively flat during quiet sleep stages 2 and 3. ICP variations and pressure waves seem to be related to cerebrovascular changes associated with sleep. The physiological ICP variations during sleep must be known in order to allow correct interpretation of continuous ICP measurements in infants.