Abstract
In REM sleep relaxation of the geniohyoid and genioglossus muscles have been shown, which will result in an increase in the intrinsic resistive load of the upper airway. To determine the role of this increase in load on paradoxical chest wall movement (CWM) noted in preterm infants during REM sleep, CWM in REM was compared to CWM in NREM and CWM in NREM with external inspiratory flow resistive loading in 5 preterm infants. Abdominal wall and CWM were measured by Hg strain-gauges, sleep state evaluation included EOG and EEG and a stable load (L) of 100 cm H2O/L/sec by face-mask and one-way valve was used. Mean ± SEM BW was 1.42 ± 0.19 kg, GA was 31.8 ± 1.5 wks and post-natal age was 5.8 ± 1.53 wks. In NREM sleep, the respiratory rate was 66.6 ± 13.3 breaths/min, Ti was 0.46 secs ± 0.04 secs, Ti/Ttot was 0.50 ± 0.01 and there was a delay between abdomen and chest rise (A-C lag) of 0.21 ± 0.07 sec, which was 22.5 ± 6.4% of Ttot (% delay). In comparison to NREM, both REM and NREM + L produced significant prolongation of A-C lag and % delay. The A-C lag was 0.46 ± 0.11 sec in REM, p<0.05, and 0.33 ± 0.08 sec in NREM + L, p<0.01. The % delay was 40.7 ± 5.3 in REM, p<0.05, and 29.9 ± 6.5% in NREM + L, p<0.01. Only NREM + L increased Ti significantly to 0.63 ± 0.05 sec, p<0.05, and Ti/Ttot to 0.58 ± 0.01, p<0.05. These data indicate that raising the inspiratory flow resistive load of the upper respiratory system increases chest lag independent of other factors accompanying sleep state change.
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Duara, S., Bessard, K. DUPLICATION OF THE CHEST LAG IN REM SLEEP BY INSPIRATORY FLOW-RESISTIVE LOADING IN NREM SLEEP. Pediatr Res 18 (Suppl 4), 390 (1984). https://doi.org/10.1203/00006450-198404001-01781
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DOI: https://doi.org/10.1203/00006450-198404001-01781