Maturation of ventilation and ventilatory pattern in normal sleeping infants

1979 ◽  
Vol 46 (5) ◽  
pp. 998-1002 ◽  
Author(s):  
G. G. Haddad ◽  
R. A. Epstein ◽  
M. A. Epstein ◽  
H. L. Leistner ◽  
P. A. Marino ◽  
...  
Keyword(s):  
Duty Cycle ◽  
Rem Sleep ◽  
Cycle Time ◽  
Age Groups ◽  
Inspiratory Flow ◽  
Inspiratory Time ◽  
Sleep State ◽  
Quiet Sleep ◽  
Ventilatory Pattern ◽  
Inspiratory Activity

Noninvasive studies of ventilation and ventilatory pattern were performed serially in 15 normal infants in the first 4 mo of life during REM and quiet sleep with the barometric method. We measured tidal volume (VT), total respiratory cycle time (Ttot), inspiratory time (Ti), expiratory time (TE), mean inspiratory flow (VT/TI), and respiratory “duty cycle” (TI/Ttot). Vt, Ttot, TI, TE, VT/TI, and VT/Ttot but not TI/Ttot increased with age. In all age groups, Ttot, TI, and TE but not VT/TI were greater in quiet than in REM sleep. In the first 2 mo of life, VT was greater in quiet than in REM sleep; in the older infants, VT/Ttot was smaller in quiet than in REM sleep. TI/Ttot was not dependent on sleep state. Thus, because VT/Ttot = VT/TI X TI/Ttot, the increase in VT/Ttot with age results from an increase in mean inspiratory flow rather than from changes in respiratory “duty cycle”. Further, the “on-switching” as well as the “off-switching” of inspiratory activity depends on sleep state.

Breath-to-breath variations in rate and depth of ventilation in sleeping infants

1982 ◽  
Vol 243 (1) ◽  
pp. R164-R169
Author(s):  
G. G. Haddad ◽  
T. L. Lai ◽  
M. A. Epstein ◽  
R. A. Epstein ◽  
K. F. Yu ◽  
...  
Keyword(s):  
Tidal Volume ◽  
Linear Relationship ◽  
Eye Movement ◽  
Rem Sleep ◽  
Cycle Time ◽  
Strong Correlation ◽  
Inspiratory Time ◽  
Quiet Sleep ◽  
Positive Linear Relationship ◽  
Inspiratory Activity

Ventilatory measurements were made noninvasively over 2- to 3-h periods during sleep in each of nine normal infants at 1 mo of age. To assess the changes that occur in ventilation on a breath-to-breath basis, we 1) examined the variations of each of tidal volume (VT), respiratory cycle time (Ttot), expiratory time (TE), and inspiratory time (TI) and 2) studied their interrelationships. We found that the variations of VT, Ttot, and TE but not of TI were significantly greater in rapid-eye-movement (REM) than in quiet sleep. In addition, on a breath-to-breath basis, VT had a positive linear relationship and strong correlation with TI; however, the correlation between VT and TE was weak in both sleep states. VT/Ttot was found to be moderately and negatively correlated with Ttot in both REM and quiet sleep. VT was weakly correlated with Ttot in REM sleep and was, on the average, more correlated with Ttot in quiet sleep. We suggest that in infants 1) on a breath-to-breath basis, VT/Ttot is likely to drop if respiratory frequency is decreased and 2) VT is nonlinearly related to Ttot during sleep; this lack of linearity depends on the lack of constancy of VT/Ttot, which is in turn closely related to the variability of the "on-switching" of inspiratory activity.

CO2-induced changes in ventilation and ventilatory pattern in normal sleeping infants

1980 ◽  
Vol 48 (4) ◽  
pp. 684-688 ◽  
Author(s):  
G. G. Haddad ◽  
H. L. Leistner ◽  
R. A. Epstein ◽  
M. A. Epstein ◽  
W. K. Grodin ◽  
...  
Keyword(s):  
Rem Sleep ◽  
Minute Ventilation ◽  
Base Line ◽  
Inspiratory Time ◽  
Sleep State ◽  
Quiet Sleep ◽  
Ventilatory Pattern ◽  
Percent Increase ◽  
Consistent Change ◽  
Induced Changes

The effect of CO2 on the ventilatory pattern of 18 normal infants was studied during sleep at monthly intervals through the age of 4 mo. Using the barometric method, we measured tidal volume (VT), respiratory cycle time (Ttot), inspiratory time (TI), and expiratory time (TE). Two percent CO2 produced no change in TI and a significant increase in VT and mean inspiratory flow (VT/TI). There was no consistent change in TE or Ttot in either sleep state at any age. The percent increase from base line in instantaneous minute ventilation (VT/Ttot) during REM sleep was similar to that during quiet sleep. We conclude that with inhalation of 2% CO2 in the first 4 mo of life 1) the increase in VT/Ttot results solely from an increase in VT and the percent increase in VT/Ttot is the same in both sleep states and 2) the reflex termination of inspiration by inflation does not play an important role in eupnea during sleep because the increase in VT is not associated with a decrease in TI.

Maturation of ventilatory response to hypoxia in puppies during sleep

1982 ◽  
Vol 52 (2) ◽  
pp. 309-314 ◽  
Author(s):  
G. G. Haddad ◽  
M. R. Gandhi ◽  
R. B. Mellins
Keyword(s):  
Rem Sleep ◽  
Ventilatory Response ◽  
Minute Ventilation ◽  
Blood Gases ◽  
Inspiratory Time ◽  
Sleep State ◽  
Quiet Sleep ◽  
Steady Level ◽  
The Mean ◽  
Ventilatory Response To Hypoxia

Using the barometric method, we studied the maturation of the ventilatory response to steady-level hypoxia (FIO2 = 15%O2) during sleep in 37 beagle puppies. In rapid-eye-movement (REM) sleep, instantaneous minute ventilation (VT/Ttot) and mean inspiratory time (VT/TI) increased, and inspiratory time (TI) and expiratory time (TE) were shortened in response to hypoxia at all the ages studied (14, 19, 24, 29 days). In quiet sleep, however, VT/Ttot decreased, and TE and Ttot were prolonged at 14 days in response to the same hypoxic stimulus. There was no change in VT/Ttot at 19 and 24 days of age, but VI/Ttot and VT/TI increased, and TI and TE were shortened at 29 days of age in response to hypoxia in the same sleep state. The mean arterial O2 tension (PaO2) dropped during hypoxia to about 45 Torr, and the mean arterial CO2 tension (PaCO2) decreased, and the mean pH increased at all ages in both REM and quiet sleep. We conclude that in beagles puppies 1) the ventilatory response to hypoxia matures at a slower rate in quiet than in REM sleep and depends primarily on timing rather than volume mechanisms: and 2) in response to hypoxia, the regulation of blood gases in REM sleep may be achieved differently from that in quiet sleep in early life.

Congenital Central Hypoventilation and Sleep State

PEDIATRICS ◽  
1980 ◽  
Vol 66 (3) ◽  
pp. 425-428
Author(s):  
Peter J. Fleming ◽  
Darlene Cade ◽  
M. Heather Bryan ◽  
A. Charles Bryan
Keyword(s):  
Metabolic Control ◽  
Eye Movement ◽  
Rem Sleep ◽  
Ventilatory Response ◽  
Respiratory Control ◽  
Rapid Eye Movement ◽  
Sleep State ◽  
Quiet Sleep ◽  
Awake State ◽  
Central Hypoventilation

Congenital central hypoventilation (Ondine's curse) is described in an infant with persistant symptoms throughout the first nine months of life. Respiratory control was most severely affected in quiet sleep, although abnormalities were present in rapid eye movement (REM) sleep and while awake. Failure of metabolic control in quiet sleep led to profound hypoventilation. Behavioral or "behavioral-like" inputs in the awake state and REM sleep increased ventilation, but not to expected normal levels. The ventilatory response to inhaled 4% CO2 was markedly depressed in all states.

Effects of Peak Inspiratory Flow on Development of Ventilator-induced Lung Injury in Rabbits

2004 ◽  
Vol 101 (3) ◽  
pp. 722-728 ◽  
Author(s):  
Yoshiko Maeda ◽  
Yuji Fujino ◽  
Akinori Uchiyama ◽  
Nariaki Matsuura ◽  
Takashi Mashimo ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Lung Injury ◽  
Cycle Time ◽  
Inspiratory Flow ◽  
Control Mode ◽  
Volume Control ◽  
Control Group ◽  
Inspiratory Time ◽  
Peak Inspiratory Flow ◽  
Volume Control Mode

Background A lung-protecting strategy is essential when ventilating acute lung injury/acute respiratory distress syndrome patients. Current emphasis is on limiting inspiratory pressure and volume. This study was designed to investigate the effect of peak inspiratory flow on lung injury. Methods Twenty-four rabbits were anesthetized, tracheostomized, ventilated with a Siemens Servo 300, and randomly assigned to three groups as follows: 1) the pressure regulated volume control group received pressure-regulated volume control mode with inspiratory time set at 20% of total cycle time, 2) the volume control with 20% inspiratory time group received volume-control mode with inspiratory time of 20% of total cycle time, and 3) the volume control with 50% inspiratory time group received volume-control mode with inspiratory time of 50% of total cycle time. Tidal volume was 30 ml/kg, respiratory rate was 20 breaths/min, and positive end-expiratory pressure was 0 cm H2O. After 6 h mechanical ventilation, the lungs were removed for histologic examination. Results When mechanical ventilation started, peak inspiratory flow was 28.8 +/- 1.4 l/min in the pressure regulated volume control group, 7.5 +/- 0.5 l/min in the volume control with 20% inspiratory time group, and 2.6 +/- 0.3 l/min in the volume control with 50% inspiratory time group. Plateau pressure did not differ significantly among the groups. Gradually during 6 h, Pao2 in the pressure regulated volume control group decreased from 688 +/- 39 to a significantly lower 304 +/- 199 mm Hg (P < 0.05) (mean +/- SD). The static compliance of the respiratory system for the pressure regulated volume control group also ended significantly lower after 6 h (P < 0.05). Wet to dry ratio for the pressure regulated volume control group was larger than for other groups (P < 0.05). Macroscopically and histologically, the lungs of the pressure regulated volume control group showed more injury than the other groups. Conclusion When an injurious tidal volume is delivered, the deterioration in gas exchange and respiratory mechanics, and lung injury appear to be marked at a high peak inspiratory flow.

Cricothyroid muscle responses to increased chemical drive in awake normal humans

1991 ◽  
Vol 70 (5) ◽  
pp. 2233-2241 ◽  
Author(s):  
J. R. Wheatley ◽  
A. Brancatisano ◽  
L. A. Engel
Keyword(s):  
Lead Time ◽  
Upper Airway ◽  
Inspiratory Flow ◽  
Inspiratory Time ◽  
Cricothyroid Muscle ◽  
Inspiratory Muscles ◽  
Inspiratory Activity ◽  
Normal Humans ◽  
Muscle Responses ◽  
Muscle Ct

To examine the response of the cricothyroid muscle (CT) to increased chemical drive, we measured its electromyogram simultaneously with that of the alae nasi (AN) in seven normal awake subjects. During both progressive hyperoxic hypercapnia and hypoxia, peak integrated inspiratory activity (moving time average, MTA) of the CT and AN increased as a power function of mean inspiratory flow (ratio of tidal volume to inspiratory time, VT/TI), given by MTA = a(VT/TI)b + c (where a, b, and c are constants). The exponent b varied from 0.009 to 3.4 among subjects but was correlated between CT and AN both during hypercapnia (r = 0.86) and hypoxia (r = 0.81). The onset of inspiratory activity of the CT and AN preceded that of inspiratory flow. Expressed as a percentage of expiratory time, the CT lead time rose from 7% at rest to 20% during hyperpnea. The corresponding values for the AN were from 22 to 52% (both P less than 0.03). Thus the pattern of response of the CT and AN is similar and related to that of the inspiratory muscles in a curvilinear manner. The findings suggest that during chemical stimulation the electrical activity of the CT is analogous to that of the AN, an upper airway dilator.

Determination of ventilatory pattern in REM sleep in normal infants

1982 ◽  
Vol 53 (1) ◽  
pp. 52-56 ◽  
Author(s):  
G. G. Haddad ◽  
T. L. Lai ◽  
R. B. Mellins
Keyword(s):  
Eye Movements ◽  
Tidal Volume ◽  
Rem Sleep ◽  
Cycle Time ◽  
Minute Ventilation ◽  
Respiratory Cycle ◽  
Ventilatory Pattern ◽  
Consistent Change ◽  
The Mean

Using methods that we devised for detecting and counting eye movements on the electrooculogram (EOG), we studied tidal volume (VT) and total respiratory cycle time (Ttot) as a function of the frequency of rapid eye movements (REM) during REM sleep in nine normal infants at 1 mo of age. In each of the nine infants, the mean VT and mean Ttot decreased with increasing frequency of eye movements. Instantaneous minute ventilation (VT/Ttot or V), however, did not change with the frequency of eye movements. In addition, there was no consistent change in the variability of VT, Ttot, or V when studied as a function of the frequency of eye movements. Our data support the notion that the ventilatory pattern in REM sleep depends in part on mechanisms that are inherent to REM sleep.

Genioglossus and breathing responses to airway occlusion: effect of sleep and route of occlusion

1988 ◽  
Vol 64 (2) ◽  
pp. 543-549 ◽  
Author(s):  
F. G. Issa ◽  
P. Edwards ◽  
E. Szeto ◽  
D. Lauff ◽  
C. Sullivan
Keyword(s):  
Rem Sleep ◽  
Slow Wave Sleep ◽  
Upper Airway ◽  
Linear Increase ◽  
Inspiratory Time ◽  
Sleep State ◽  
Airway Occlusion ◽  
Pressure Changes ◽  
Occlusion Effect

We examined the effect of sleep state on the response of genioglossus muscle (EMGgg) activity to total airway occlusion applied at 1) nasal (N) airway [and thus exposing the upper airway (UAW) to pressure changes] and 2) tracheal (T) airway (thus excluding UAW from pressure changes). A total of 233 tests were performed during wakefulness (W), 98 tests in slow-wave sleep (SWS), and 72 tests in rapid-eye-movement (REM) sleep. Prolongation of inspiratory time (TI) of the first occluded effort occurred in all tests irrespective of behavioral state, with the greatest increase seen in awake N tests. Nasal tests augmented EMGgg activity in the first occluded breath and produced a linear increase in EMGgg during occlusion. The EMGgg activity at any given time during nasal occlusion in SWS was less than that recorded during W tests. There was a marked reduction in EMGgg response to N occlusion during REM sleep. The EMGgg activity during awake T tests was significantly less than that of N tests at any given time during occlusion. There was no relationship between the level of EMGgg activity and asphyxia in T tests performed during SWS and REM sleep. Nasal tests decreased the force generated by the inspiratory pump muscles and the central drive to breathing compared with T tests. These results confirm the important role of the UAW in regulating breathing pattern and indicate that both immediate and progressive load-compensating responses during nasal occlusion are influenced by information arising from the UAW.

scholarly journals The effect of leptin replacement on sleep-disordered breathing in the leptin-deficient ob/ob mouse

2016 ◽  
Vol 120 (1) ◽  
pp. 78-86 ◽  
Author(s):  
H. Pho ◽  
A. B. Hernandez ◽  
R. S. Arias ◽  
E. B. Leitner ◽  
S. Van Kooten ◽  
...  
Keyword(s):  
Airway Obstruction ◽  
Duty Cycle ◽  
Rem Sleep ◽  
Minute Ventilation ◽  
Upper Airway ◽  
Neuromuscular Control ◽  
Inspiratory Flow ◽  
Upper Airway Obstruction ◽  
Airflow Limitation ◽  
Breathing Patterns

Obese leptin-deficient ( ob/ob) mice demonstrate defects in upper airway structural and neuromuscular control. We hypothesized that these defects predispose to upper airway obstruction during sleep, and improve with leptin administration. High-fidelity polysomnographic recordings were conducted to characterize sleep and breathing patterns in conscious, unrestrained ob/ob mice (23 wk, 67.2 ± 4.1 g, n = 13). In a parallel-arm crossover study, we compared responses to subcutaneous leptin (1 μg/h) vs. vehicle on respiratory parameters during NREM and REM sleep. Upper airway obstruction was defined by the presence of inspiratory airflow limitation (IFL), as characterized by an early inspiratory plateau in airflow at a maximum level (V̇imax) with increasing effort. The severity of upper airway obstruction (V̇imax) was assessed along with minute ventilation (V̇e), tidal volume (VT), respiratory rate (RR), inspiratory duty cycle, and mean inspiratory flow at each time point. IFL occurred more frequently in REM sleep (37.6 ± 0.2% vs. 1.1 ± 0.0% in NREM sleep, P < 0.001), and leptin did not alter its frequency. V̇imax (3.7 ± 1.1 vs. 2.7 ± 0.8 ml/s, P < 0.001) and V̇e increased (55.4 ± 22.0 vs. 39.8 ± 16.4 ml/min, P < 0.001) with leptin vs. vehicle administration. The increase in V̇e was due to a significant increase in VT (0.20 ± 0.06 vs. 0.16 ± 0.05 ml, P < 0.01) rather than RR. Increases in V̇e were attributable to increases in mean inspiratory flow (2.5 ± 0.8 vs. 1.8 ± 0.6 ml/s, P < 0.001) rather than inspiratory duty cycle. Similar increases in V̇e and its components were observed in non-flow-limited breaths during NREM and REM sleep. These responses suggest that leptin stabilized pharyngeal patency and increased drive to both the upper airway and diaphragm during sleep.

Sleep State Organization in Normal Infants and Victims of the Sudden Infant Death Syndrome

PEDIATRICS ◽  
1992 ◽  
Vol 89 (5) ◽  
pp. 865-870 ◽  
Author(s):  
Vicki L. Schechtman ◽  
Ronald M. Harper ◽  
Arian J. Wilson ◽  
David P. Southall
Keyword(s):  
Sudden Infant Death Syndrome ◽  
Rem Sleep ◽  
Infant Death ◽  
Sudden Infant Death ◽  
Early Morning ◽  
Sudden Infant ◽  
Sleep State ◽  
Quiet Sleep ◽  
Increased Risk ◽  
State Organization

Infants at increased risk of the sudden infant death syndrome (SIDS) show abnormal patterning of sleep-waking states. It was hypothesized that infants who were to die of SIDS would show abnormalities of sleep state distribution prior to their deaths. Twenty-two 12-hour recordings were obtained from infants who subsequently died of SIDS, and sleep state patterns were compared in these records and 66 records of age-matched control infants. Each 1-minute epoch was classified as quiet sleep, rapid eye movement (REM) sleep, waking, indeterminate state, or artifact-contaminated. Victims of SIDS showed less waking and more sleep than control infants during the early-morning hours. Victims of SIDS younger than 1 month of age showed significantly more epochs classified as REM sleep across the night and significantly fewer epochs contaminated by artifacts relative to control infants. Further analysis indicated that the increased number of REM epochs resulted from fewer artifact-contaminated epochs, suggesting reduced motility during REM sleep in the SIDS victims compared with the control infants. The finding of decreased waking time during the early morning is of particular importance since most SIDS deaths occur during this portion of the day. The findings of altered sleep patterns in SIDS victims suggest that central neural changes are associated with SIDS risk.

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