Abstract
Patterns of events occurring at the end of apneas have rarely been reported in infants. No previous studies have compared these patterns to those of spontaneous events during sleep. We examined 163 isolated apneas in 17 infants (47 ± 4 wk postconceptional age) who underwent polysomnography for suspected upper airway problems. Mean apnea duration was 6.5 ± 1.5 s (range, 5 to 11.5 s), 78% of apneas occurred in active sleep, and 67% of apneas were obstructive. We recorded the occurrence of body movement or augmented breath and analyzed changes in EEG frequency ≥ 1 s, heart rate, and oxygen saturation value at the end of apneas and of a control ventilatory period defined as a period of breathing equal in duration to the apnea and preceding the apnea by 1 min. We found that 7.9% of apneas and 11.6% of control periods were followed by an augmented breath and that 14.1% of apneas and 0.5% of control periods were followed by a body movement. The percentages of motor events or no event differed significantly after the apneas (p= 0.008) compared with the control periods. A significant increase in EEG frequency was observed at the end of the apneas compared with the control periods (p< 0.04). EEG frequency increased after 61% of the apneas. Neither heart rate nor oxygen saturation value changed after the control periods. Heart rate decreased significantly after the apneas not followed by a motor event (p= 0.02) but not after the apneas followed by a body movement. We conclude that 1) at termination of isolated apneas in infants, a motor event was rare, whereas an EEG frequency increase was common;2) event patterns at apnea termination differed from those at control period termination.
Similar content being viewed by others
Log in or create a free account to read this content
Gain free access to this article, as well as selected content from this journal and more on nature.com
or
Abbreviations
- AS:
-
active sleep
- IS:
-
indeterminate sleep
- QS:
-
quiet sleep
- ALTE:
-
apparently life-threatening event
References
Curzi-Dascalova L, Plassart E 1978 Respiratory and motor events in sleeping infants: their correlation with thoraco-abdominal relationships. Early Hum Dev 2: 39–50
Schultz H, Massetani R, Fagioli G, Salzarulo P 1985 Spontaneous awakening from sleep in infants. Electroencephal Clin Neurophysiol 6: 267–271
Vecchierini-Blineau MF, Nogues B, Louvet S, Desfontaines O 1994 Maturation de la motilité généralisée, spontanée au cours du sommeil, de la naissance à terme à l'âge de 6 mois. Neurophysiol Clin 24: 141–154
Lijowska AS, Reed NW, Mertins Chiodini BA, Thach BT 1997 Sequential arousal and airway-defensive behavior of infants in asphyxial sleep environments. J Appl Physiol 83: 219–228
McNamara F, Wulbrand H, Thach BT 1998 Characteristics of the infant arousal response. J Appl Physiol 85: 2314–2321
McGinty DJ, London MS, Baker TL, Stevenson M, Hoppenbrouwers TH, Harper RM, Sterman MB, Hodgman J 1979 Sleep apnea in normal kittens. Sleep 1: 393–421
Orem J, Trotter H 1993 Medullary respiratory neuronal activity during augmented breaths in intact unanesthetized cats. J Appl Physiol 74: 761–769
Thoppil CK, Belan MA, Cowen CP, Mathew OP 1991 Behavioral arousal in newborn infants and its association with termination of apnea. J Appl Physiol 70: 2479–2484
McNamara F, Issa FG, Sullivan CE 1996 Arousal pattern following central and obstructive breathing abnormalities in infants and in children. J Appl Physiol 81: 2651–2657
Weintraub Z, Alvaro R, Mills S, Cates D, Rigatto H 1994 Short apneas in their relationship to body movements and sighs in preterm infants. Biol Neonate 66: 188–194
Guilleminault C, Souquet M 1979 Sleep states and related pathology. In Korobkin R, Guilleminault C (eds) Advance in Perinatal Neurology. SP Medical and Scientific Book, New York, 225–247.
Curzi-Dascalova L, Mirmiran M 1996 Manual of Methods of Recording and Analyzing Sleep-Wakefulness States in Preterm and Full-term Infants. INSERM, Paris, 1–162.
American Thoracic Society 1996 Standards and indications for cardiopulmonary sleep studies in children. Am J Respir Crit Care Med 153: 866–878
Curzi-Dascalova L, Bloch J, Vecchierini MF, Bedu A, Vignolo P 2000 Physiological parameters evaluation following apnea in healthy premature infants. Biol Neonat 77: 203–212
Hoppenbrouwers T, Hodgman JE, Cabal L 1993 Obstructive apnea, associated patterns of movement, heart rate, and oxygenation in infants at low and increased risk for SIDS. Pediatr Pulmonol 15: 1–12
Guilleminault C, Pelayo R, Leger D, Clerk A, Bocian CZ 1996 Recognition of sleep-disordered breathing in children. Pediatrics 98: 871–882
Kahn A, Groswasser J, Sottiaux M, Franco P, Dramaix M 1993 Prone and supine body position and sleep characteristics in infants. Pediatrics 91: 1112–1115
Franco P, Groswasser J, Sottiaux M, Broadfield E, Kahn A 1996 Decreased cardiac responses to auditory stimulation during prone sleep. Pediatrics 97: 174–178
Kahn A, Groswasser J, Rebuffat E, Sottiaux M, Blum D, Foerster M, Franco P, Bochner A, Alexander M, Bachy A 1992 Sleep and cardiorespiratory characteristics of infant victims of sudden death: a prospective case-control study. Sleep 15: 287–292
McNamara F, Sullivan CE 1999 Effects of nasal CPAP therapy on respiratory and spontaneous arousals in infants with OSA. J Appl Physiol 87: 889–896
Curzi-Dascalova L, Kauffmann F, Gaultier C, Caldas de Amorim RH 1999 Heart rate modifications related to spontaneous body movements in sleeping premature and full-term newborns. Pediatr Res 45: 515–518
Eiselt M, Curzi-Dascalova L, Leffler CH, Christova E 1992 Sigh-related heart rate changes during sleep in premature and full-term newborns. Neuropediatrics 23: 286–291
EEG arousals scoring rules and examples 1992 A preliminary report from the sleep disorders atlas task force of the American Sleep Disorders Association. Sleep 15: 174–184.
Associazione Italiana di Medicina del Sonno 1997 Phasic event appearing in all stages of sleep. In: Terzano MG, Parrino L, Mennuni GF (eds) Phasic Events and Microstructure of Sleep. Martano, Lecce, 114–120.
Mograss MA, Ducharme FM, Brouillette RT 1994 Description, classification, and relationship to sleep apnea in children. Am J Respir Crit Care Med 150: 1690–1696
McNamara F, Sullivan CE 1999 Obstructive sleep apnea in infants and its management with nasal continuous positive airway pressure. Chest 116: 10–16
Praud JP, D'Allest AM, Nedelcoux H, Curzi-Dascalova L, Guilleminault C, Gaultier C 1989 Sleep-related abdominal muscle behavior during partial or complete obstructed breathing in prepubertal children. Pediatr Res 26: 347–350
Author information
Authors and Affiliations
Additional information
Supported by grants from Université Paris VII (EA 2379) and INSERM E 9935.
Rights and permissions
About this article
Cite this article
Vecchierini, MF., Curzi-Dascalova, L., Trang-Pham, H. et al. Patterns of EEG Frequency, Movement, Heart Rate, and Oxygenation after Isolated Short Apneas in Infants. Pediatr Res 49, 220–226 (2001). https://doi.org/10.1203/00006450-200102000-00015
Received:
Accepted:
Issue date:
DOI: https://doi.org/10.1203/00006450-200102000-00015
This article is cited by
-
Respiratory Development in Preterm Infants
Journal of Perinatology (2004)
