Apneic preterms and methylxanthines: arousal deficits, sleep fragmentation and suppressed spontaneous movements.
OBJECTIVE
To determine if apneic preterm infants currently treated with methylxanthines develop evidence of sleep deprivation from cumulative arousal and motor activational effects.


METHODS
Sleep, wake, arousal and actigraphic movements were monitored in extubated clinically stable premature infants (N=37). Neonates were free of other medications for >72 h and were grouped based on methylxanthine exposure: >5 days with caffeine (n=14), >5 days theophylline (n=13) or no prior exposure (n=10).


RESULTS
Duration of methylxanthine treatment predicted increased arousals, wakefulness and actigraphic movements, and decreased active sleep. Recording from 1200 to 0500 hours, methylxanthine-treated groups showed reductions in all arousal parameters: waking state, number of wake epochs, brief arousals and composite arousal index, and shorter fast-burst, sleep-related motility than untreated controls.


CONCLUSIONS
In apneic preterms, chronic methylxanthine treatment appears to produce sleep deprivation secondary to the stimulatory action of methylxanthines on arousal and motor systems.
Hayes
M J
MJ
Graduate School of Biomedical Sciences, University of Maine, Orono, ME, USA. Mhayes@maine.edu
Akilesh
M R
MR
Fukumizu
M
M
Gilles
A A
AA
Sallinen
B A
BA
Troese
M
M
Paul
J A
JA
D001049:Apnea / Q000188:drug therapy*; D001143:Arousal / Q000187:drug effects*; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature / Q000502:physiology; D008297:Male; D009068:Movement / Q000187:drug effects*; D019141:Respiratory System Agents / Q000494:pharmacology* / Q000627:therapeutic use; D012892:Sleep Deprivation; D014970:Xanthines / Q000494:pharmacology* / Q000627:therapeutic use