Bhat Ravindra Y, Hannam Simon, Pressler Ronit, Rafferty Gerrard F, Peacock Janet L, Greenough Anne
Division of Asthma, Allergy, and Lung Biology, King's College London School of Medicine at Guy's King's College and St Thomas' Hospitals, London, United Kingdom.
Pediatrics. 2006 Jul;118(1):101-7. doi: 10.1542/peds.2005-1873.
Prematurely born compared with term born infants are at increased risk of sudden infant death syndrome, particularly if slept prone. The purpose of this work was to test the hypothesis that preterm infants with or without bronchopulmonary dysplasia being prepared for neonatal unit discharge would sleep longer and have less arousals and more central apneas in the prone position.
This was a prospective observational study in a tertiary NICU. Twenty-four infants (14 with bronchopulmonary dysplasia) with a median gestational age of 27 weeks were studied at a median postconceptional age of 37 weeks. Video polysomnographic recordings of 2-channel electroencephalogram, 2-channel electro-oculogram, nasal airflow, chest and abdominal wall movements, limb movements, electrocardiogram, and oxygen saturation were made in the supine and prone positions, each position maintained for 3 hours. The duration of sleep, sleep efficiency (total sleep time/total recording time), and number and type of apneas, arousals, and awakenings were recorded.
Overall, in the prone position, infants slept longer, had greater sleep efficiency (89.5% vs 72.5%), and had more central apneas (median: 5.6 vs 2.2), but fewer obstructive apneas (0.5 vs 0.9). The infants had more awakenings (9.7 vs 3.5) and arousals per hour (13.6 vs 9.0) when supine. There were similar findings in the bronchopulmonary dysplasia infants.
Very prematurely born infants studied before neonatal unit discharge sleep more efficiently with fewer arousals and more central apneas in the prone position, emphasizing the importance of recommending supine sleeping after neonatal unit discharge for prematurely born infants.
与足月儿相比，早产儿发生婴儿猝死综合征的风险更高，尤其是俯卧睡眠时。本研究旨在验证以下假设：准备从新生儿重症监护病房出院的有或没有支气管肺发育不良的早产儿，俯卧位睡眠时睡眠时间更长、觉醒次数更少且中枢性呼吸暂停更多。
这是一项在三级新生儿重症监护病房进行的前瞻性观察性研究。研究对象为24例婴儿（14例患有支气管肺发育不良），中位胎龄为27周，中位孕龄后年龄为37周。在仰卧位和俯卧位分别进行2通道脑电图、2通道眼电图、鼻气流、胸壁和腹壁运动、肢体运动、心电图和血氧饱和度的视频多导睡眠图记录，每个体位保持3小时。记录睡眠时间、睡眠效率（总睡眠时间/总记录时间）以及呼吸暂停、觉醒和清醒的次数及类型。
总体而言，俯卧位时婴儿睡眠时间更长，睡眠效率更高（89.5%对72.5%），中枢性呼吸暂停更多（中位数：5.6对2.2），但阻塞性呼吸暂停更少（0.5对0.9）。仰卧位时婴儿每小时的清醒次数（9.7对3.5）和觉醒次数更多（13.6对9.0）。支气管肺发育不良婴儿也有类似的发现。
在新生儿重症监护病房出院前研究的极早产儿，俯卧位睡眠时睡眠效率更高，觉醒次数更少且中枢性呼吸暂停更多，这强调了建议早产儿在新生儿重症监护病房出院后仰卧睡眠的重要性。
