Effect of sleep stages on measurements of passive respiratory mechanics in infants with bronchiolitis.
The measurement of passive respiratory mechanics by the single-breath occlusion technique is one of the more frequently used tests of infant lung function. Measurements are routinely done under chloral hydrate sedation, and a possible influence of sleep stages on these measurements has not been evaluated so far. We combined the assessment of passive respiratory mechanics with sleep stage monitoring in 44 infants and toddlers with mild to moderately severe bronchiolitis. In 31 infants, only nonrapid eye movement (NREM) sleep was recorded. In 13 patients who showed both NREM and rapid eye movement (REM) sleep, compliance of the respiratory system was significantly lower during REM than NREM sleep (73.2 +/- 19.7 vs. 81.2 +/- 21.3 mL/kPa, P = 0.0007), while resistance remained essentially unchanged. This finding was explained by an unchanged airway opening pressure in combination with a significantly decreased extrapolated volume. As tidal volume did not change from NREM to REM, this indicates reduced dynamic elevation of lung volume during REM sleep and thus supports previous observations of decreased lung volume in this sleep stage. From a practical perspective, these findings argue for the monitoring of sleep stage during measurements of passive respiratory mechanics, thereby increasing the complexity of these measurements significantly.
Pratl
B
B
Pediatric Department, University of Graz, Austria.
Steinbrugger
B
B
Weinhandl
E
E
Zach
M S
MS
D001990:Bronchiolitis, Viral / Q000503:physiopathology*; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D012129:Respiratory Function Tests; D015656:Respiratory Mechanics / Q000502:physiology*; D012894:Sleep Stages / Q000502:physiology*