SLEEP AND CARDIORESPIRATORY CHARACTERISTICS OF INFANT VICTIMS OF SUDDEN-DEATH - A PROSPECTIVE CASE-CONTROL STUDY
SLEEP AND CARDIORESPIRATORY CHARACTERISTICS OF INFANT VICTIMS OF SUDDEN-DEATH - A PROSPECTIVE CASE-CONTROL STUDY
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DOI：
10.1093/sleep/15.4.287
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发表时间：
1992-08-01
期刊：
影响因子：
5.6
通讯作者：
WAYENBERG, JL
中科院分区：
文献类型：
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作者：
KAHN, A;GROSWASSER, J;WAYENBERG, JL
我们研究了30名最终死于婴儿猝死综合征(SID)的婴儿和60名匹配的对照组婴儿的多导睡眠记录。所有记录都是从10个睡眠实验室前瞻性收集的20750项睡眠研究中提取出来的。在未来的30名小岛屿发展中国家受害者中，5人是小岛屿发展中国家受害者的兄弟姐妹，9人在一次明显危及生命的事件后进行了研究。对于每个SIDS患者，两名正常对照组婴儿在性别、胎龄、出生后年龄和出生时体重方面匹配。据报道，与对照组相比，未来的SIDs婴儿在喂养后出现更频繁的反流(p=0.01)，在睡眠中大量出汗(p=0.01)。只有两个多导睡眠图变量表征了未来的婴儿猝死综合征。与对照组相比，SIDS婴儿在睡眠中活动较少(p=0.04)，呼吸障碍事件的频率明显更高。阻塞性和混合性呼吸暂停在未来30名SID患者中有23名出现，而在60名对照组中只有9名(p=0.01)。阻塞性呼吸暂停和混合性呼吸暂停持续时间比对照组长(p=0.01)，但不超过15秒。呼吸障碍主要发生在快速眼动睡眠中(78%)，并伴有心率下降至每分钟68次，血氧饱和度下降至75%。本报告进一步间接证明，在一些最终死于小岛屿发展中国家的婴儿中，可能存在与睡眠有关的呼吸控制障碍。
We studied the polygraphic sleep recordings of 30 infants who eventually died of sudden infant death syndrome (SIDS) and those of 60 matched control infants. All records were extracted from 20,750 sleep studies collected prospectively in 10 sleep laboratories. Of the 30 future SIDS victims, 5 were siblings of SIDS victims and 9 were studied after an apparent life-threatening event. For each SIDS victim, two normal control infants were matched for sex, gestational age, postnatal age and weight at birth. The future SIDS infants were reported to have more frequent episodes of regurgitations after feeding (p = 0.01) and profuse sweating during sleep (p = 0.01) than the control subjects. Only two polysomnographic variables characterized the future SIDS infants. Compared to control subjects, the SIDS infants moved less during sleep (p = 0.04) and had significantly more frequent obstructed breathing events. Obstructive and mixed apneas were seen in 23 of 30 future SIDS victims, but in only 9 of 60 control subjects (p = 0.01). The obstructed and mixed apneas lasted longer in the SIDS than in the control infants (p = 0.01) but did not exceed 15 seconds. The obstructed breaths occurred mainly in rapid eye movement sleep (78% of the events).and were accompanied by drops in heart rates to 68 beats per minute and in SaO2 levels to 75%. The present report adds further indirect evidence for a possible sleep-related impairment of respiratory control in some infants who eventually died of SIDS.