Baroreflex Sensitivity During Sleep in Infants: Impact of Sleeping Position and Sleep State

Overview

Journal Sleep

Publisher Oxford University Press

Specialty Psychiatry

Date 2011 Jun 2

PMID 21629360

Citations 11

Authors

Stephanie R Yiallourou

Scott A Sands

Adrian M Walker

Rosemary S C Horne

Affiliations

Soon will be listed here.

Abstract

Study Objectives: The prone sleeping position is a major risk for the sudden infant death syndrome (SIDS) and has been associated with lowered blood pressure and impaired blood pressure control. This study aimed to assess the effects of sleeping position, sleep state, and postnatal age on baroreflex control of heart rate.

Participants: Term infants (n = 31) were studied at 2-4 weeks, 2-3 months, and 5-6 months with daytime polysomnography.

Interventions: Blood pressure and heart rate were recorded during quiet (QS) and active (AS) sleep in both the supine and prone positions. In each condition, three 1-2 minute baseline measurements and three 15° head-up tilts were performed.

Measurements And Results: Baroreflex sensitivity (BRS) was assessed using cross-spectral analysis (BRS(SP)) and sequence analysis (BRS(SEQ)) in the baseline condition and with BRS(SP) during head-up tilting (BRS(SP) Tilt). BRS was usually lower prone compared to supine, reaching significance at 2-3 months (BRS(SP), P < 0.05; BRS(SP) Tilt, P < 0.05) and 5-6 months (BRS(SEQ), P < 0.05). BRS was lower in AS than QS supine at 5-6 months for all BRS estimates (P < 0.05). During QS, BRS increased with postnatal age in both sleeping positions (P < 0.05 for all BRS estimates); during AS, the postnatal age-related increase was limited to the prone position (BRS(SEQ), P < 0.05).

Conclusions: Sleeping position, sleep state and postnatal age all affect infant baroreflex function. Reduced BRS in the younger infants sleeping prone could increase the vulnerability to hypotensive events during sleep and thus play a vital role in conditions where circulatory failure may be involved, such as SIDS.

Citing Articles

Sudden Infant Death Syndrome: Risk Factors and Newer Risk Reduction Strategies.

Vincent A, Chu N, Shah A, Avanthika C, Jhaveri S, Singh K Cureus. 2023; 15(6):e40572.

PMID: 37465778 PMC: 10351748. DOI: 10.7759/cureus.40572.

Effect of sleep position in term healthy newborns on sudden infant death syndrome and other infant outcomes: A systematic review.

Priyadarshi M, Balachander B, Sankar M J Glob Health. 2022; 12:12001.

PMID: 35838069 PMC: 9284601. DOI: 10.7189/jogh.12.12001.

Prone sleeping affects cardiovascular control in preterm infants in NICU.

Shepherd K, Wong F, Odoi A, Yeomans E, Horne R, Yiallourou S Pediatr Res. 2020; 90(1):197-204.

PMID: 33173173 DOI: 10.1038/s41390-020-01254-z.

Is prone sleeping dangerous for neonates? Polysomnographic characteristics and NDN gene analysis.

Wong S, Zhao L, Chuang S, Tsai W, Yu C, Tsai L Tzu Chi Med J. 2019; 31(2):113-117.

PMID: 31007492 PMC: 6450148. DOI: 10.4103/tcmj.tcmj_29_18.

Fetal-growth-restricted preterm infants display compromised autonomic cardiovascular control on the first postnatal day but not during infancy.

Cohen E, Wong F, Wallace E, Mockler J, Odoi A, Hollis S Pediatr Res. 2017; 82(3):474-482.

PMID: 28388597 DOI: 10.1038/pr.2017.105.

References

Legramante J, Marciani M, Placidi F, Aquilani S, Romigi A, Tombini M . Sleep-related changes in baroreflex sensitivity and cardiovascular autonomic modulation. J Hypertens. 2003; 21(8):1555-61. DOI: 10.1097/00004872-200308000-00021. View

Andriessen P, Oetomo S, Peters C, Vermeulen B, Wijn P, Blanco C . Baroreceptor reflex sensitivity in human neonates: the effect of postmenstrual age. J Physiol. 2005; 568(Pt 1):333-41. PMC: 1474770. DOI: 10.1113/jphysiol.2005.093641. View

De BURGH DALY M . Interaction of cardiovascular reflexes. Sci Basis Med Annu Rev. 1972; :307-32. View

Panigrahy A, Filiano J, Sleeper L, Mandell F, VALDES-DAPENA M, Krous H . Decreased kainate receptor binding in the arcuate nucleus of the sudden infant death syndrome. J Neuropathol Exp Neurol. 1997; 56(11):1253-61. DOI: 10.1097/00005072-199711000-00010. View

Galland B, Reeves G, Taylor B, Bolton D . Sleep position, autonomic function, and arousal. Arch Dis Child Fetal Neonatal Ed. 1998; 78(3):F189-94. PMC: 1720791. DOI: 10.1136/fn.78.3.f189. View

Andriessen P, Koolen A, Berendsen R, Wijn P, ten Broeke E, Oei S . Cardiovascular fluctuations and transfer function analysis in stable preterm infants. Pediatr Res. 2003; 53(1):89-97. DOI: 10.1203/00006450-200301000-00016. View

Galland B, Hayman R, Taylor B, Bolton D, Sayers R, Williams S . Factors affecting heart rate variability and heart rate responses to tilting in infants aged 1 and 3 months. Pediatr Res. 2000; 48(3):360-8. DOI: 10.1203/00006450-200009000-00017. View

Yiallourou S, Sands S, Walker A, Horne R . Postnatal development of baroreflex sensitivity in infancy. J Physiol. 2010; 588(Pt 12):2193-203. PMC: 2911220. DOI: 10.1113/jphysiol.2010.187070. View

Cohen G, Vella S, Jeffery H, Lagercrantz H, Katz-Salamon M . Cardiovascular stress hyperreactivity in babies of smokers and in babies born preterm. Circulation. 2008; 118(18):1848-53. DOI: 10.1161/CIRCULATIONAHA.108.783902. View

10.

Ledwidge M, Fox G, Matthews T . Neurocardiogenic syncope: a model for SIDS. Arch Dis Child. 1998; 78(5):481-3. PMC: 1717554. DOI: 10.1136/adc.78.5.481. View

11.

Kinney H, Filiano J, Sleeper L, Mandell F, VALDES-DAPENA M, White W . Decreased muscarinic receptor binding in the arcuate nucleus in sudden infant death syndrome. Science. 1995; 269(5229):1446-50. DOI: 10.1126/science.7660131. View

12.

Bland J, Altman D . Comparing methods of measurement: why plotting difference against standard method is misleading. Lancet. 1995; 346(8982):1085-7. DOI: 10.1016/s0140-6736(95)91748-9. View

13.

Robbe H, Mulder L, Ruddel H, Langewitz W, Veldman J, Mulder G . Assessment of baroreceptor reflex sensitivity by means of spectral analysis. Hypertension. 1987; 10(5):538-43. DOI: 10.1161/01.hyp.10.5.538. View

14.

Galland B, Taylor B, Bolton D, Sayers R . Vasoconstriction following spontaneous sighs and head-up tilts in infants sleeping prone and supine. Early Hum Dev. 2000; 58(2):119-32. DOI: 10.1016/s0378-3782(00)00070-0. View

15.

Moon R, Horne R, Hauck F . Sudden infant death syndrome. Lancet. 2007; 370(9598):1578-87. DOI: 10.1016/S0140-6736(07)61662-6. View

16.

Chatow U, Davidson S, Reichman B, Akselrod S . Development and maturation of the autonomic nervous system in premature and full-term infants using spectral analysis of heart rate fluctuations. Pediatr Res. 1995; 37(3):294-302. DOI: 10.1203/00006450-199503000-00008. View

17.

Drouin E, Gournay V, Calamel J, Mouzard A, Roze J . Feasibility of using finger arterial pressure in neonates. Arch Dis Child Fetal Neonatal Ed. 1998; 77(2):F139-40. PMC: 1720683. DOI: 10.1136/fn.77.2.f139. View

18.

Segar J . Ontogeny of the arterial and cardiopulmonary baroreflex during fetal and postnatal life. Am J Physiol. 1997; 273(2 Pt 2):R457-71. DOI: 10.1152/ajpregu.1997.273.2.R457. View

19.

Chong A, Murphy N, Matthews T . Effect of prone sleeping on circulatory control in infants. Arch Dis Child. 2000; 82(3):253-6. PMC: 1718241. DOI: 10.1136/adc.82.3.253. View

20.

Franco P, Groswasser J, Sottiaux M, Broadfield E, Kahn A . Decreased cardiac responses to auditory stimulation during prone sleep. Pediatrics. 1996; 97(2):174-8. View