Advertisement

Lung

, Volume 168, Supplement 1, pp 905–911 | Cite as

Respiratory adaptation during sleep in infants

  • C. Gaultier
Neurogenic Disorders Of Breathing And Sudden Infant Death Syndrome

Abstract

Respiratory adaptation during sleep improves with growth. The most vulnerable period for respiratory adaptation to sleep is from birth to 3 months of age. Factors that favor vulnerability are immaturity in ventilatory control and high rib cage compliance which impairs its effectiveness for ventilation. Improvement in respiratory adaptation during sleep is rapid during the first year of life. Sleep, and especially active (REM) sleep, is a risk period for respiratory disturbances in infants. Numerous factors may trigger apparent life threatening events. Respiratory disorders such as bronchiolitis, upper airway obstruction, and bronchopulmonary dysplasia impair respiratory adaptation during sleep. Treatment of respiratory disorders in infants must take into account the exacerbation of respiratory disturbances during sleep.

Key words

Respiratory adaptation Sleep Ventilatory control Rib cage compliance Infants 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Berterottière D, D’Allest AM, Nedelcoux H, Dehan M, Gaultier CI (1989) Effects of increase in body temperature on breathing pattern during sleep in healthy infants. Submitted for publicationGoogle Scholar
  2. 2.
    Boggs DF, Bartlett D (1982) Chemical specificity of a laryngeal apneic reflex in puppies. J Appl Physiol 53:455–462PubMedGoogle Scholar
  3. 3.
    Bryan AC, Gaultier Cl (1985) Chest wall mechanics in the newborn. In: Roussos C, Macklem PT, Eds. The Thorax. New York: Marcel Dekker, 871–888Google Scholar
  4. 4.
    Canet E, Gaultier Cl, D’Allest AM, Dehan M (1989) Effect of sleep deprivation on respiratory events during sleep in healthy infants. J Appl Physiol 66:1158–1163PubMedGoogle Scholar
  5. 5.
    Coons S, Guilleminault C (1982) Development of sleep wake patterns and non-rapid eye movement sleep stages during the first six months of life in normal infants. Pediatrics 69:793–798PubMedGoogle Scholar
  6. 6.
    Curzi-Dascalova L (1978) Thoracic-abdominal respiratory correlations in infants: constancy and variability in different sleep states. Early Hum Dev 2:25–38PubMedCrossRefGoogle Scholar
  7. 7.
    Davies AM, Koenig JS, Thach BT (1988) Upper airway chemoreflex responses to saline and water in preterm infants. J Appl Physiol 64:1412–1420PubMedGoogle Scholar
  8. 8.
    Davis GM, Bureau MA (1987) Pulmonary and chest wall mechanics in the control of respiration in the newborn. Clinics in Perinatology 14:551–579PubMedGoogle Scholar
  9. 9.
    Downing SE, Lee JC (1975) Laryngeal chemosensitivity: a possible mechanism for sudden infant death. Pediatrics 55:640–649PubMedGoogle Scholar
  10. 10.
    Fisher JT, Mathew OP, San’Ambrogio FB, San’Ambrogio G (1985) Reflex effects and receptors: responses airway pressure and flow stimuli in developing puppies. J Appl Physiol 58:258–264PubMedGoogle Scholar
  11. 11.
    Gaultier Cl (1985) Breathing and sleep during growth: physiology and pathology. Bull Eur Physiopathol Respir 21:55–112PubMedGoogle Scholar
  12. 12.
    Gaultier Cl, Praud JP, Canet E, Delaperche MF, D’Allest AM (1987) Paradoxical inward rib cage motion during rapid eye movement sleep in infants and young children. J Dev Physiol 9:391–397PubMedGoogle Scholar
  13. 13.
    Gaultier Cl, Bobin S, Praud JP, Delaperche MF (1989) Syndrome d’apnées obstructives du sommeil du nourrisson et de l’enfant. In: Gaultier Cl, ed. Pathologie respiratoire du sommeil du nourrisson et de l’enfant. Paris: Vigot, 69–77Google Scholar
  14. 14.
    Guilleminault C, Ariagno R, Korobkin R, Nagell L, Baldwin R, Coons S, Owen M (1979) Mixed and obstructive sleep apnea and near-miss for sudden infant death syndrome. 2. Comparison of near-miss and normal control infants by age. Pediatrics 64:882–891PubMedGoogle Scholar
  15. 15.
    Guslits BG, Gaston SE, Bryan MH, England SJ, Bryan AC (1987) Diaphragmatic work of breathing in premature human infants. J Appl Physiol 62:1410–1415PubMedGoogle Scholar
  16. 16.
    Jansen AH, Chermick V (1983) Development of respiratory control. Physiol Rev 63:437–483PubMedGoogle Scholar
  17. 17.
    Herbst JJ, Minton SD, Book LS (1979) Gastroesophageal reflux causing respiratory distress and apnea in newborn infants. J Pediatr 95:763–768PubMedCrossRefGoogle Scholar
  18. 18.
    Henderson-Smart DJ, Read DJ (1979) Reduced lung volume during behavioral sleep in the newborn. J Appl Physiol 46:1081–1085PubMedGoogle Scholar
  19. 19.
    Honma Y, Wilkes D, Bryan MH, Bryan AC (1984) Rib-cage and abdominal contributions to the ventilatory response to CO2 in infants. J Appl Physiol 56:1211–1216PubMedGoogle Scholar
  20. 20.
    Hunt CE, McCulloch K, Brouillette RT (1981) Diminished ventilatory responses in near-miss sudden infant death syndrome. J Appl Physiol 50:1313–1317PubMedGoogle Scholar
  21. 21.
    Hunt CE, Bouillette RT (1987) Sudden infant death syndrome: 1987 perspective. J Pediatr 110:669–677PubMedCrossRefGoogle Scholar
  22. 22.
    Kahn A, Rebuffat E, Sottiaux M, Levitt J, Bachner A, Alexander M, Grosswasser J, Muller MF (1988) Polysomnographic studies of infants who subsequently died of sudden infant death syndrome. Pediatrics 82:721–727PubMedGoogle Scholar
  23. 23.
    Keens TG, Bryan AC, Levison H, Ianuzzo CD (1978) Development pattern of muscle fiber types in human ventilatory muscles. J Appl Physiol 44:909–913PubMedGoogle Scholar
  24. 24.
    Lee JC, Downing SE (1980) Laryngeal reflex inhibition of breathing in piglets: influences of anemia and catecholamine depletion. Am J Physiol 239(Regulatory Integrative Comp Phyiol, 8):R 25-R 30Google Scholar
  25. 25.
    Lesouef PN, Lopes JM, England SJ, Bryan MH, Bryan AC (1983) Effect of chest wall distortion on occlusion pressure and the preterm diaphgram. J Appl Physiol 55:359–364PubMedGoogle Scholar
  26. 26.
    Lucier GE, Story AT, Sessle BJ (1979) Effects of upper respiratory tract stimuli on neonatal respiration: reflex and single neuron analyses in kitten. Biol Neonate 35:82–89PubMedCrossRefGoogle Scholar
  27. 27.
    Martin RJ, Okken A, Rubin D (1979) Arterial oxygen tension during active and quiet sleep. J Pediatr 94:271–274PubMedCrossRefGoogle Scholar
  28. 28.
    McCulloch K, Brouillette RT, Guzetta AJ, Hunt CE (1983) Arousal responses in near-miss sudden infant death syndrome and in normal infants. J Pediatr 101:911–917Google Scholar
  29. 29.
    Mok JY, McLaughlin FJ, Pintar M, Hak H, Amazo-Galvez R, Levison H (1986) Transcutaneous monitoring of oxygenation: what is normal? J Pediatr 118:365–371Google Scholar
  30. 30.
    Moriette G, Van Reempt P, Moore M, Cates D, Rigatto H (1985) The effect of rebreathing CO2 on ventilation diaphragmatic electromyography in newborn infants. Respir Physiol 62:387–397PubMedCrossRefGoogle Scholar
  31. 31.
    Muller N, Gulston G, Whitton CJ, Froese AB, Bryan MH, Bryan AC (1979) Diaphragmatic muscle fatigue in the newborn. J Appl Physiol 46:688–695PubMedGoogle Scholar
  32. 32.
    Navelet Y, Benoit O, Brouard G (1982) Nocturnal sleep organisation during the first months of life. Electroenceophalogr Clin Neurophysiol 54:71–78CrossRefGoogle Scholar
  33. 33.
    Openshaw P, Edwards S, Helms P (1984) Changes in rib cage geometry during childhood. Thorax 39:624–627PubMedCrossRefGoogle Scholar
  34. 34.
    Perkett EA, Vaughan R (1982) Evidence for laryngeal chemo-reflex in some human preterm infants. Acta Pediatr Scand 71:969–972CrossRefGoogle Scholar
  35. 35.
    Pickens DL, Schefft G, Thach BT (1988) Prolonged apnea associated with upper airway protective reflexes in apnea of prematurity. Am Rev Respir Dis 137:113–118PubMedGoogle Scholar
  36. 36.
    Pickens DL, Schefft GL, Storch GA, Thach BT (1989) Characterization of prolonged apneic episodes associated with respiratory syncytial virus infection. Pediatr Pulmonol 6:195–201PubMedCrossRefGoogle Scholar
  37. 37.
    Phillipson EA, Bowes G (1986) Control of breathing during sleep. In: Cherniak NS, Widdicombe JC, eds. The respiratory system, volume II. Control of Breathing, part 2. American Physiological Society, 641–690Google Scholar
  38. 38.
    Praud JP (1989a) Perturbations respiratoires au cours du sommeil des dysplasies bronchopulmonaires. In: Gaultier Cl, ed. Pathologie respiratoire du sommeil du nourrisson et de l’enfant. Paris: Vigot, 102–108Google Scholar
  39. 39.
    Praud JP, Benlabed M, Egreteau L, Curzi L, Gaultier Cl (1989b) Sleep related abdominal muscle behavior in infant during rebreathing CO2. Am Rev Respir Dis 139:A82Google Scholar
  40. 40.
    Purcell M (1976) Response in the newborn to raised upper airway resistance. Arch Dis Child 51:602–607PubMedCrossRefGoogle Scholar
  41. 41.
    Rigatto H, Brady JP (1972) Periodic breathing and apnea in preterm infants. II. Hypoxia as a primary event. Pediatrics 50:219–228PubMedGoogle Scholar
  42. 42.
    Rigatto H, Brady JP, De La Torre Verduzzo R (1975) Chemoreceptor reflexes in preterm infants: I. The effect of gestational and postnatal age on the ventilatory response to inhalation of 100% and 15% oxygen. Pediatrics 65:604–613Google Scholar
  43. 43.
    Rigatto H, Kalapesi L, Leahy FN, Durant M, Mac Callum M, Cates D (1982) Ventilatory response to 100% and 15% O2 during wakefulness in preterm infants. Early Human Dev 7:1–10CrossRefGoogle Scholar
  44. 44.
    Rodenstein DO, Perlemuter N, Stanescu DC (1976) Infants are not obligatory nasal breathers. Am Rev Respir Dis 131:343–347Google Scholar
  45. 45.
    Swift PG, Emery JL (1973) Clinical observations on the respones to nasal occlusion in infancy. Arch Dis Child 48:947–951PubMedCrossRefGoogle Scholar
  46. 46.
    Steinschneider A, Weinstein S (1983) Sleep respiratory instability in term neonates under hyperthermic conditions: age, sex, type of feeding, and rapid eye movements. Pediatr Res 17:35–41PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag New York Inc 1990

Authors and Affiliations

  • C. Gaultier
    • 1
  1. 1.Laboratory of PhysiologyHôpital Antoine BéclèreClamartFrance

Personalised recommendations