Maturation of Heart Rate and Blood Pressure Variability during Sleep in Term-Born Infants

被引:71
作者
Yiallourou, Stephanie R.
Sands, Scott A. [2 ,3 ]
Walker, Adrian M.
Horne, Rosemary S. C. [1 ]
机构
[1] Monash Univ, Monash Med Ctr, Ritchie Ctr, Monash Inst Med Res, Melbourne, Vic 3168, Australia
[2] Harvard Univ, Sch Med, Boston, MA USA
[3] Brigham & Womens Hosp, Div Sleep Med, Boston, MA 02115 USA
基金
英国医学研究理事会;
关键词
Autonomic control; sympathetic activity; parasympathetic activity; sudden infant death syndrome; SYMPATHETIC-NERVE ACTIVITY; POWER SPECTRAL-ANALYSIS; DEATH-SYNDROME; PRETERM INFANTS; BAROREFLEX SENSITIVITY; AUTONOMIC ACTIVITY; ARTERIAL-PRESSURE; HUMANS; LIFE; SIDS;
D O I
10.5665/sleep.1616
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Study Objectives: Abnormal blood pressure control is implicated in the sudden infant death syndrome (SIDS). However, no data exist on normal development of blood pressure control during infancy. This study assessed maturation of autonomic control of blood pressure and heart rate during sleep within the first 6 months of life. Participants: Term infants (n = 31) were studied longitudinally at 2-4 weeks, 2-3 months, and 5-6 months postnatal age. Interventions: Infants underwent daytime polysomnography at each age studied. Blood pressure and heart rate were recorded during quiet (QS) and active (AS) sleep in undisturbed baseline and head-up tilt conditions. Measurements and Results: Autonomic control was assessed using spectral indices of blood pressure and heart rate variability (BPV and HRV) in ranges of low frequency (LF, reflecting sympathetic + parasympathetic activity) and high frequency (HF, parasympathetic activity), total power (LF+HF), and LF/HF ratio (sympathovagal balance). With increasing postnatal age and predominantly during QS, HRV-LF, HRV-HF, and HRV total power increased, while HRV-LF/HF decreased. BPV-LF/HF also decreased with postnatal age. All changes were evident in both baseline and head-up tilt conditions. BPV-LF and BPV total power during tilts were markedly reduced in QS versus AS at each age. Conclusions: In sleeping infants, sympathetic vascular modulation of the circulation decreases with age, while parasympathetic control of heart rate is strengthened. These normative data will aid in the early identification of conditions where autonomic function is impaired, such as in SIDS.
引用
收藏
页码:177 / 186
页数:10
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