Medline ® Abstracts for References 78,79
of 'Evaluation of suspected obstructive sleep apnea in children'
Effects of sleep deprivation on respiratory events during sleep in healthy infants.
Canet E, Gaultier C, D'Allest AM, Dehan M
J Appl Physiol (1985). 1989;66(3):1158.
This study was designed to determine the effects of sleep deprivation on respiratory events during sleep in healthy infants. Ten unsedated full-term infants (1-6 mo) were monitored polygraphically during "afternoon naps" on a control day and on the day after sleep deprivation. Respiratory events, i.e., central apnea, obstructive apnea and hypopnea, and periodic breathing were tabulated. Results for respiratory events were expressed as 1) indexes of the total number of respiratory events and of specific respiratory events per hour of total sleep (TST), "quiet" sleep (QS) and "active" sleep (AS) times; 2) total duration of total and specific respiratory events, expressed as a percentage of TST, QS, and AS times. After sleep deprivation, significant increases were observed for 1) respiratory event (P less than 0.001), central apnea (P less than 0.05), and obstructive respiratory event (P less than 0.01) indexes; 2) respiratory event time as a percentage of TST (P less than 0.002) and as a percentage of AS time (P less than 0.001); 3) obstructive respiratory event time as a percentage of TST (P less than 0.01), QS (P less than 0.05), and AS times (P less than 0.002). The present study shows that short-term sleep deprivation in healthy infants increases the number and timing of respiratory events, especially obstructive events in AS.
Department of Physiology, Centre National de la Recherche Scientifique UnitéAssociée 1159, Clamart, France.
The effect of chloral hydrate on genioglossus and diaphragmatic activity.
Hershenson M, Brouillette RT, Olsen E, Hunt CE
Pediatr Res. 1984;18(6):516.
A child presented with obstructive sleep apnea (OSA) and a near-fatal airway obstruction and respiratory arrest shortly after receiving chloral hydrate (CH). We, therefore, hypothesize that CH might selectively depress upper airway maintaining muscles such as the genioglossus and so predispose to airway obstruction. Genioglossus (GG) and diaphragmatic (DIA) integrated electromyograms (I EMGs) were recorded in four cats and four rabbits before and after hypnotic doses of CH ranging from 200-1000 mg/kg. Results were similar in both species. Peak GG I EMG decreased within 10-20 min after CH in seven of eight animals. Average peak GG I EMGs were decreased from 100% before CH to as low as 37.0 +/- 27.2% (SD) after CH (P less than 0.001). Minimum GG I EMGs fell from 47.2 +/- 27.2% of peak values before CH to as low as 16.0 +/- 9.7% after CH (P less than 0.01). Phasic GG I EMGs decreased from 53.8 +/- 25.1% of peak control activity to as low as 20.6 +/- 24.6% after CH (P less than 0.05). By contrast, peak and phasic DIA I EMGs after CH were not significantly different from those before CH administration. We conclude that hypnotic doses of CH may preferentially depress GG activity as compared with DIA activity. Selective depression of airway-maintaining muscular contraction by CH may place susceptible patients at risk for life-threatening airway obstruction and may preclude the use of CH to facilitate sleep for polygraphic evaluations in patients suspected of having OSA.