Of sleep state and postnatal age on arousal responses induced by mild hypoxia in infants.
OBJECTIVE
It has been suggested that mild hypoxia may not be a potent stimulus for arousal during sleep in infants because infants frequently fail to arouse from quiet sleep (QS). Our aim was to characterize arousal responses of sleeping infants in both active sleep (AS) and QS under normoxic and mildly hypoxic (15% O2) conditions over the first 6 months of life.


METHODS
Five healthy term and 6 healthy preterm infants were each studied at 2 to 5 weeks, 2 to 3 months, and 5 to 6 months postterm. All infants underwent daytime polysomnography during which nasal airflow was monitored using a purpose-built pneumotachograph. All infants were studied under both normoxic (21% O2) and hypoxic (15% O2, balance N2) conditions (presentation order randomized) in each sleep state at each study age. Tests were terminated at arousal, O2 saturation falling below 85%, or 5 minutes (failure to arouse).


METHODS
Probability of failure to arouse and mean arousal latency were compared between each experimental condition, with each infant serving as its own control.


RESULTS
Infants aroused more frequently under hypoxic conditions than under normoxic conditions. Overall, arousal latencies were shorter during hypoxia compared to normoxia in both sleep states at each age. Arousal latencies were longer in QS compared to AS in both hypoxic and normoxic conditions.


CONCLUSIONS
In sleeping infants, mild hypoxia serves as a stimulus for arousal in both AS and QS. Of particular significance is our finding that arousal from AS is readily elicited by mild hypoxia.
Department of Paediatrics and Ritchie Centre for Baby Health Research, Monash University, Melbourne, Victoria.
Peter M
PM
Parslow
Richard
R
Harding
T Michael
TM
Adamson
Rosemary S C
RS
Horne
D001143:Arousal / Q000502:physiology*; D001921:Brain / Q000378:metabolism; D005260:Female; D006801:Humans; D000860:Hypoxia / Q000175:diagnosis / Q000378:metabolism / Q000503:physiopathology*; D007231:Infant, Newborn; D008297:Male; D010100:Oxygen / Q000378:metabolism; D011897:Random Allocation; D012720:Severity of Illness Index; D012890:Sleep / Q000502:physiology*
D010100:Oxygen