Groswasser J, Simon T, Scaillet S, Franco P, Kahn A
Sleep and Development Unit, University Children's Hospital Queen Fabiola, Free University of Brussels, 1020 Brussels, Belgium.
Pediatr Res. 2001 Mar;49(3):402-6. doi: 10.1203/00006450-200103000-00015.
A decreased arousability and an increased risk for sudden infant death syndrome (SIDS) have been shown in infants sleeping prone. Obstructive apnea, a known risk factor for SIDS, is less often terminated by an arousal reaction in infants than in adults. The effect of body position on the arousal reaction to spontaneous respiratory events had not been previously studied in infants. The aim of our study was to see if body position has an influence on the frequency and delay of the arousal reaction to obstructive apnea. All obstructive events recorded during two successive nights in 20 infants sleeping one night prone and one night supine were studied. During the supine recording 153 obstructive events were detected, and 217 were detected during the prone session. Prone sleep was not associated with an increased frequency of obstructive apneas. Total sleep time was 382 min (range, 283-456) supine and 423 min (range, 325-521) prone (p = 0.003). Obstructive events duration was 6.5 s (range, 3-21.5) when sleeping supine and 8 s (range, 3.5-30.5) when prone (p = 0.002). Behavioral arousal were found in 57.5 % of obstructive events recorded supine and in 31.3 % of those seen prone (p < 0.001). Arousal occurred after 8 s (range, 0-21) from the start of the obstructions when supine and 10.5 s (range, 3.5-23.5) when prone (p = 0.001). Sighs were found in 34 % of supine obstructive events and in 44.7 % of those prone (p = 0.040). A reaction, i.e. arousal or sigh, was found in 91.5 % of supine events and 76 % of those prone (p < 0.001). We conclude that when sleeping supine, infants arouse to obstructive events more often and after shorter delay than when prone.
研究表明，俯卧睡眠的婴儿觉醒能力下降，患婴儿猝死综合征（SIDS）的风险增加。阻塞性呼吸暂停是SIDS的一个已知风险因素，与成人相比，婴儿因阻塞性呼吸暂停引发的觉醒反应终止该症状的情况较少见。此前尚未研究过体位对婴儿自发呼吸事件觉醒反应的影响。我们研究的目的是观察体位是否会对阻塞性呼吸暂停觉醒反应的频率和延迟产生影响。对20名婴儿连续两晚的睡眠情况进行了研究，其中一晚为俯卧睡眠，另一晚为仰卧睡眠。在仰卧睡眠记录期间检测到153次阻塞性事件，俯卧睡眠期间检测到217次。俯卧睡眠与阻塞性呼吸暂停频率增加无关。仰卧睡眠总时长为382分钟（范围283 - 456分钟），俯卧睡眠总时长为423分钟（范围325 - 521分钟）（p = 0.003）。仰卧睡眠时阻塞性事件持续时间为6.5秒（范围3 - 21.5秒），俯卧睡眠时为8秒（范围3.5 - 30.5秒）（p = 0.002）。仰卧睡眠记录的阻塞性事件中有57.5%出现行为觉醒，俯卧睡眠时这一比例为31.3%（p < 0.001）。仰卧睡眠时，阻塞开始后8秒（范围0 - 21秒）出现觉醒，俯卧睡眠时为10.5秒（范围3.5 - 23.5秒）（p = 0.001）。仰卧睡眠的阻塞性事件中有34%出现叹息，俯卧睡眠时这一比例为44.7%（p = 0.040）。仰卧睡眠事件中有91.5%出现反应（即觉醒或叹息），俯卧睡眠时为76%（p < 0.001）。我们得出结论，与俯卧睡眠相比，婴儿仰卧睡眠时对阻塞性事件的觉醒更频繁，延迟时间更短。
