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Sleep state, cardiorespiratory and electrocortical activity in infants with transposition of great vessels
1Department of Pediatrics, College of Physicians and Surgeons, Columbia University, New York, NY, USA.
Insights
Infants with Transposition of Great Vessels (TGV) show distinct sleep states even with low oxygen. Correcting hypoxemia significantly alters physiological measures during quiet and active sleep.
Area of Science:
- Neonatal physiology
- Pediatric cardiology
- Sleep medicine
Background:
- Sleep states and physiological changes offer insights into brain function.
- Infants with Transposition of Great Vessels (TGV) experience hypoxemia, potentially affecting sleep patterns.
Purpose of the Study:
- To determine if infants with TGV exhibit recognizable sleep states under hypoxemia.
- To investigate the impact of hypoxemia correction on physiological characteristics of sleep in TGV infants.
Main Methods:
- Cardiorespiratory and electrocortical recordings in five term infants with TGV, pre- and postoperatively.
- Sleep states were assigned, and state-dependent variables (heart rate, variability, respiratory frequency, EEG) were analyzed.
- Comparison of physiological measures during quiet and active sleep between preoperative and postoperative periods.
Main Results:
- Infants with TGV demonstrated distinct state-dependent variables in both preoperative (80.9% O2 saturation) and postoperative (92.8% O2 saturation) states.
- Postoperatively, infants exhibited lower heart rate and heart rate variability, and increased EEG power during quiet sleep.
- During active sleep, heart rate, heart rate variability, and respiratory frequency variability decreased, while EEG power increased postoperatively.
- The percentage of quiet sleep increased, and active sleep decreased after hypoxemia correction.
Conclusions:
- Infants with TGV display identifiable sleep states even under isocapnic hypoxemia.
- Correction of hypoxemia leads to significant, measurable changes in physiological variables during both quiet and active sleep states.
Objectives:
Sleep states and physiological changes during sleep may be useful in assessing brain function. We hypothesized that infants with transposition of great vessels (TGV) exhibit recognizable states of sleep under conditions of isocapnic hypoxemia. Also, we speculated that early correction of hypoxemia may result in significant changes in the physiological characteristics of quiet and active sleep.
Methods:
Six-hour continuous cardiorespiratory and electrocortical recordings were performed in five term infants with TGV, pre- and postoperatively along with simultaneous minute by minute behavioral sleep state assignment. Data were sorted for sleep states and percent sleep time for each state was computed. Measurements of state-dependent variables, i.e., heart rate (HR), heart rate variability (HRSD), respiratory frequency (f), variability in respiratory frequency (fSD), and spectral properties of the EEG during quiet and active sleep were compared for both pre- and postoperative periods.
Results:
All infants showed significant differences in state-dependent variables between quiet and active sleep, both during preoperative (mean O2 saturation = 80.9 +/- 2.8) and postoperative (mean O2 saturation = 92.8 +/- 0.5) periods. As compared to preoperative period, postoperatively during quiet sleep, HR and HRSD were lower, and EEG power was greater; and during active sleep, HR, HRSD, and fSD decreased and EEG power increased. Also, in the postoperative period % quiet sleep increased and % active sleep decreased.
Conclusions:
Under conditions of isocapnic hypoxemia infants with TGV vessels exhibit clearly recognizable states of sleep. Correction of hypoxemia is associated with significant changes in state-dependent variables both during quiet and active sleep.